Women in your situation are rightfully confused about the safety of ERT. Many such women do not want to take it and many physicians do not prescribe it. According to the National Institutes of Health, the risk of breast cancer doubles for a woman whose mother or sister has had the disease. If the mother’s cancer began before menopause, her daughter’s risk is slightly higher. Deciding to take estrogen replacement therapy in such situations often boils down to a quality of life issue weighing uncomfortable or debilitating menopausal symptoms against these risks. With this kind of family history and in cases of debilitating menopausal symptoms some physicians may, occasionally, consider carefully monitored short-term estrogen therapy. Doses vary and a very low dose of estrogen may solve your problem.
I HAVE HAD BREAST CANCER. CAN I TAKE ERT? The answer is usually no. If you have had cancer in one breast, your risk of getting it again is four to five times higher than for women who have not had breast cancer. National Institutes of Health studies indicate that longterm ERT increases the risk of breast cancer slightly.
Other studies do not confirm this, however. This is why you and your doctor must carefully analyze your personal risk. That analysis should include tests to determine whether your cancer was hormone-fed. An estrogen and progesterone receptor test can tell whether these hormones promoted the growth of the cancer. This information may help your doctor to decide whether hormone treatment is possible for you.
Suppose you had breast cancer and cannot TAKE ERT. Is THERE AN ALTERNATIVE?
Chapter 10 details nonhormonal therapies for the symptoms of menopause. Many of these practices work very well for women who cannot or do not wish to take hormones.
What is the new drug that is under consideration FOR BLOCKING THE RECURRENCE OF BREAST CANCER OR PREVENTING IT IN HIGH-RISK WOMEN LIKE ME?
The National Cancer Institute has a new double-blind study under way of 16,000 high-risk women to see whether treatment with tamoxifen, a powerful drug, works to prevent breast cancer. Tamoxifen is believed to block cancer in the breast and to mimic the protective effects of estrogen elsewhere in the body. The results of the new study are five to eight years away. (In this double-blind study, half the women receive tamoxifen; the other half get a placebo.)