Sensationalised report on increased breast cancer risk concentrates on older HRT & ignores proven benefits

Published: 30th August 2019

An article published in The Lancet medical journal today has been sensationalised in the media suggesting that the breast cancer risk from using HRT is twice what was thought. Here, Dr Louise Newson seeks to reassure women and explain why there is no cause for panic.

"This is an epidemiological study looking at numerous studies which have been done in the past and is reporting that women who are over 50 taking HRT may have a higher risk of breast cancer than previously thought. However, there is no need to panic and I am certainly not going to stop taking my HRT. This is not a randomised controlled study which is the gold standard study to demonstrate cause and effect. 

The facts

HRT containing estrogen with older types of progestogen have a higher risk compared to taking estrogen only HRT, or estrogen with micronised progesterone (Utrogestan, known as body identical HRT). This report does not discuss micronised progesterone in detail. 

So many menopausal women have put on weight due to the metabolic changes that occur during the perimenopause and menopause and also due to eating the wrong types of food (often women “comfort” eat to try and improve how they feel). Many women stop exercising as their motivation is low, their energy levels reduce and their joints are stiff and sore. Also women often tell me they drink more alcohol to “numb” their symptoms. Obesity, not exercising and drinking alcohol are all risk factors for developing breast cancer in the future. 

This means that women who take HRT can actually lower their future risk of breast cancer by modifying their lifestyle even if the actual HRT might increase their risk slightly. 

In addition, studies have shown that women who take HRT have a lower future risk of heart disease, osteoporosis, osteoarthritis, type 2 diabetes, depression, bowel cancer and dementia

It is essential that women receive individualised consultations regarding taking HRT and they are given all the facts regarding the benefits and risks. 

Women are seven times more likely to die from heart disease than breast cancer so taking a treatment (HRT) that lowers heart disease risk is often very important for many women."

The British Menopause Society has issued an official response to the Lancet article which states

"The overall findings from this study are in keeping with the NICE Menopause guideline recommendations which show a small increase in risk of breast cancer with HRT. Women must be informed of the data on breast cancer risk with HRT to help them make an informed decision. This should also be considered in comparison to the risk of breast cancer with other lifestyle factors such as alcohol intake and obesity which have been shown to be associated with a higher risk compared to that with HRT. This should also be taken in the context of the overall benefits obtained from using HRT including symptom control and improving quality of life as well as considering the bone and cardiovascular benefits associated with HRT use."

Read the full BMS response here

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Newson Health Menopause and Wellbeing Centre was founded by leading menopause specialist and GP, Dr Louise Newson, and officially opened in September 2018 by Liz Earle MBE. Created to help women receive the most appropriate, individualised treatment for their perimenopause and menopause, it has quickly become a centre of excellence, providing care to women of all ages, as well as running educational events for primary care clinicians.

Dr Newson is also the founder of the Menopause Doctor website, a free resource since 2017, providing the latest unbiased, evidence based information about the menopause and perimenopause for women as well as the most recent national and international menopause articles and guidelines for healthcare professionals. The website has been adopted by the Royal College of GPs (RCGP) as an official educational library aimed at patients and healthcare professionals wishing to learn more about the menopause.

Newson Health Research and Education is a not-for-profit organisation founded by Dr Newson, from which all profits gained from the organisation's activities, such as event sponsorship, delegate fees and speaker's fees, are invested back into the business.