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Would you take HRT if your mum had breast cancer?

(37 Posts)
porolli Fri 23-Nov-12 18:21:44

That's it really. My GP has confirmed an early menopause (I'm 42). She said the usual response for someone my age would be to prescribe hrt until the normal age for menopause. However my mum had breast cancer at the age if 53 which she ascribes to hrt taken from age 50. Having had 12 cancer free years she now has secondaries in bones and lungs.
I am struggling with menopausal symptoms and really don't know what to do as obviously there has (historically) been such a negative association for breast cancer risks.
Has anyone been in this position? And/or what would you do?

it's tricky- I would say no but then I have secondary bc - it's a matter of balance really- if your menopausal symptoms are making life really miserable then it seems sensible to try HRT but with a watchful eye on your breasts (that sounds weird,but you know what i mean) Horrid dilemma. Best wishes to your mum.

porolli Fri 23-Nov-12 18:30:31

Thanks for your response - i appreciate you replying - and all the best to you too

BIWI Fri 23-Nov-12 18:33:20

Absolutely no way. My mum died from advanced breast cancer. She had been on HRT.

BIWI Fri 23-Nov-12 18:35:36

What symptoms are you struggling with? I'm 53 now and it's over a year since my last period, so I'm fairly sure I'm through it (and I hope that's not tempting fate!).

My GP, in a very brief conversation, said to look at the herbal route.

TBH, the only thing I have that bothers me is the hot flushes, and they aren't really that bad. I take a Boots Menolieve tablet every evening.

The other thing that I do, which makes a massive difference, is to follow a low carb diet. Sugar is known to be something that can trigger flushes.

IslaValargeone Fri 23-Nov-12 18:37:01

I wouldn't.
I'm peri menopausal but not experiencing anything too horrendous.
My mum was diagnosed at 39 and it came back but she is 5 years free iirc.
I'm going to try all alternative routes if I get really bad symptoms.
Best wishes for your mum and yourself.

when I was on tamoxifen, which can cause menopausal symptoms my breast care nurse told me that some women take anti depressants for flushes - not sure if that is a good idea or not

RTchoke Fri 23-Nov-12 18:39:15

I wouldn't. My mother was diagnosed with breast cancer aged 58 following several years on HRT. I cannot remember the exact details but it was a kind of breast cancer more often seen in women who have had long term exposure to The Pill or HRT. Sadly my mum's cancer spread and she died just after her 64th birthday.

I will never take The Pill or HRT because I fear I am already more likely to have to face this horrible disease.

porolli Fri 23-Nov-12 18:41:02

Sorry about your mum biwi, it's really difficult I know. I'm having trouble with night sweats, mood swings and painful, dry vagina. I think maybe it's more psychological too. I'm quite shocked its happened this early and I'm finding it difficult to come to terms with. Plus I keep reading that I'm now at risk of osteoporosis and heart disease because of lack of oestrogen.

TheFarSide Fri 23-Nov-12 18:47:15

Re your dry vag, apparently there are HRT pessaries that you can apply direct to that area.

Re osteoporosis and heart disease, I have read that HRT can be beneficial but is not normally viewed as a first line treatment. In other words, there are other ways to reduce your risk.

There's quite a good summary of the pros & cons of HRT on this website which might help you make a decision:-

www.patient.co.uk/health/Menopause-and-HRT.htm

Good luck!

porolli Fri 23-Nov-12 19:01:54

Thanks to everyone who is responding. I know that this can be emotional and difficult for anyone affected by breast cancer and I wish everyone all the best

BIWI Fri 23-Nov-12 19:15:06

Re osteoporosis, the other thing to consider is exercise, especially weight-bearing exercise.

MissBoPeep Fri 23-Nov-12 19:49:30

Sorry about your mum.

You need to see a specilalist given your family history.

Remeber though that you only start counting your years on HRT re. risk AFTER the average age of the menopause- so 7 years from now to 50 would not - or should not- put you at any more risk than anyone else. But you need advice. You should really have a bone scan DXA scan now- and every 2 years to see how your bones are doing- and meanwhile do everything you can to help build your bone density. exercise- the right sort- diet, supplements etc.

There are other types of treatment for bones if you ever needed it- such as Tibolone which reduces breast cancer risk, like Tamoxifen.

There is NO WAY- sorry to shout- that your mum or any dr would know if HRT had caused her cancer. Even if breast cancer is oestrogen receptive that means it is fed by oestrogen- but not necessarily caused by taking it. I feel quite strongly about this and had a discussion with a gynae about it and that is what he said. Some drs think the HRT may hasten the growth of breast cancer if it's already there.

whizmum Fri 23-Nov-12 19:52:10

Porolli - so sorry about your mother - and it is hard to come to terms with menopause so early.

The vaginal symptoms sound the most difficult to deal with. The vaginal dryness can lead to other annoying problems. You can get oestrogen treatments and pessaries that can help with the dryness and use less than HRT and direct it where it is needed. Menopause matters have a good site to read about it. I think you can get moisturisers as well, but they do not really solve the problem.

Look at a low GI and healthy eating diet as this will keep your blood glucose levels more even - and get the right balance of fats in your diet. Diabetes UK, ArthritisCare and Heart UK have good leaflets on healthy eating. I particularly like the ArthritisCare leaflet even though I don't have arthritis!

Also, try and find some regular exercise you enjoy - I like dance; it makes me feel good, and I can't keep away!

If you could feel better and reduce your cancer risk with diet and exercise (and hopefully have great fun too!) that would be a very good thing. Good luck with it all!

MissBoPeep Fri 23-Nov-12 19:53:36

Agree that you should try HRT vaginal creams and pessaries as almost nil risk of absorption into your body and they can work very quickly to help the problem.

porolli Fri 23-Nov-12 20:02:50

Thanks for the suggestions - I'm going back to the gp next week so I think I will ask about a referral and investigate the pessaries/creams as a first step really. It feels such a minor problem compared to what my mum's going through but it's really getting me down and I wish this wasn't happening to me now

MissBoPeep Fri 23-Nov-12 21:58:07

It might be worth considering genetic counselling?

It's unlikely IMO that HRT caused your mums's cancer- after just 3 years- because statistically the risk is very very small But it's possible she had a tiny tumour at 50 and didn't know.

Has anyone suggestd early mammograms for you?

BIWI Sat 24-Nov-12 09:55:20

I'm sorry - I don't care about the statistics or the likely risk. It's a risk too far for me.

prorolli - I was offered genetic counselling, and early mammograms as well (they don't do them routinely until you're 50), and so I have been having those every year since my mum died, 8 years ago. It isn't a nice experience, but it's very reassuring.

RTchoke Sat 24-Nov-12 11:01:56

I feel the same BIWI - a risk too far for me too.

And MissBoPeep while it is true that it is "not necessarily" HRT which caused the cancer of all the others on this thread it also may have been. At least that is what my mother's specialist told us: HRT and years on the Pill.

And even if it was simply that HRT speeded the growth of a tiny existing tumour that is bad enough. That speeded-up growth might have been the difference between several years of life, or even catching the cancer before it spread.

I could never take the risk knowing that if my mother had avoided those medications she may have lived to meet and love my children, and finish the Fine Art degree that was bringing her so much joy and which she had waited her whole life to start.

FanjoForTheMammaries Sat 24-Nov-12 11:04:23

I wouldn't either, my mum also had breast cancer on HRT (7 years in remission, thankfully)

MissBoPeep Sat 24-Nov-12 14:17:53

RTChoke I am sorry to disagree but I had this conversation with my gynae recently after Jenni Murray wrote in the Mail that her oncologist had said her cancer was brought on/caused by HRT. My gynae- who is very highly qualified- said there is no way a dr would have told her that as a dr couldn't know the cause. Jenni Murray has also conceded in similar articles that she was very overweight for most of her mid life, and unfit, and drank a lot of alcohol- all of these are actually higher risk factors for breast cancer than HRT.

Even if you look at the Million Women Study on HRT- and it's now been discredited- the conclusion was that HRT was safe for most women short term- under 5 years.

I am very sorry for those of you who have mums with cancer. But you can't just look at a few case and say that this proves something. You have to look at studies and proper research.

I had a friend who had breast cancer at 37 and after years of remission died from secondaries at 52. She was slim and fit . On the other hand I know of 2 friends who took HRT for over 10 years- and they have not had breast cancer.

If anyone has a copy of today's Times there is a feature in it about your risk of cancer re. genetics. The dr writes that as women have a 1:8 chance of breast cancer over a lifetime, it's likely that we will all know someone in our family who had it. He says that even if a mother has cancer before the age of 50, it is not a given that a daughter would be more at risk. You need to go back decades- he links to a Macmillan site where you can plot your family history including aunts and grandparents.

I think if I were the OP I'd try everything esle first to help then if I was still really suffering and life was awful, then I'd take the risk.

BIWI Sat 24-Nov-12 14:25:54

You're clearly writing from the perspective of someone who hasn't been in the same situation, MissBoPeep. And there remains too much confusion about the available data - or the way it has been interpreted.

And giving us anecdotes does not make the data or our perception of the risk any different.

Menopausal symptoms vs risk of breast cancer is a very unequal contest.

MissBoPeep Sat 24-Nov-12 14:43:30

But BWIW you miss the point! ALL the women posting here about their mums- and I truly sympathise- are giving anecdotal accounts- and I was adding mine to say how worthless they are!

Maybe you have not (yet?) suffered severe menopausal symptoms? I've no idea. Only if someone has can they understand the way their quality of life suffers. True, it's not the same as having cancer- but there is no evidence that HRT automatically cuases breast cancer which is what many people here seem to be saying.

I'm pointing to the research- and if you care to google BMJ and look up the Danish study on osteoporosis you will see that they found no increased risk with breast cancer after 11+ years on it.

It's all about what matters to someone most- longevity or quality of life. Some people will opt for longevity and disregard quality oof life- other people will choose to take a calculated risk and go for quality of life.

I'm not saying HRT is blameless but I do think women should heed all advice about breast cancer risks, of which being overweight and drinking even moderately increase the risk more than HRT.

BIWI Sat 24-Nov-12 14:51:49

I am not missing the point at all hmm

The evidence on the link between HRT and cancer is contradictory - one survey says there is a link and then the next one says there isn't. I am not sufficiently convinced at this point in time either way.

Therefore it is a risk I am simply not prepared to take.

And yes, I have suffered/am suffering from some menopausal symptoms, but these are nothing compared with the suffering that would go with cancer.

Oh, and before you ask - I've recently shed two stones, have cut down on alcohol and am going to the gym regularly.

This is my life and health I am talking about. Therefore I make no apologies for being subjective about it.

MissBoPeep Sat 24-Nov-12 16:03:40

Is there any need to be so aggressive? confused Or defensive? I was replying to the OP- not you though I did reply to some of your points.
I do think you missed the point TBH.

But anyway- my posting(s) were not really aimed at you solely. I was making what I feel is a balanced discussion.

You said yourself up thread that your meno symtpoms are mild- just some mild hot flushes.

Fair enough. But not everyone's are. So in that sense you aren't in a place to judge either- are you?

What I was saying is that it's an individual choice. There is no way I'm telling you or anyone what to do, so I don't know why you've gone off on one [ confused]

MissBoPeep Sat 24-Nov-12 16:08:19

The other point is that the OP is having a premature menopause- which makes her at risk from a whole lot of potential problems which you at 53 don't have. Not the same thing at all.

orangeflutie Sat 24-Nov-12 16:12:50

OP It's a dilemma that I will have to face too.

I'm currently 44 and am probably slightly perimenopausal in that my periods are no longer regular, I often go two months without one but have no other symptoms yet.

My mother also developed breast cancer in her fifties. It was found from a mammogram and was described as a mass rather than a lump. She had been taking HRT, unfortunately I'm not sure how long but at the time the doctor and oncologist said it was extremely likely the HRT had caused the cancer. She has had a masectomy and tamoxifen and has now been in remission for over 5 years.
Fingers crossed after reading your post that nothing else develops.

For now I'm sitting on the fence but when I get into the menopause will have to look at all the pros and cons, quality of life etc.

porolli Sat 24-Nov-12 16:34:14

thanks for all your responses, it's very useful. I had decided years ago that I would never use hrt, based on my mum's belief. However I had not anticipated I would go through a premature menopause and how that would make me feel AND what I would be told about the associated long term health risks in other areas of having a premature one. What is so confusing is that there appear to be reports that hrt pre 52 ish is no different to having a normal menopause. I kind of want to believe that as I don't feel ready for this yet but I obviously need to think about my situation very carefully. My mother is now very ill indeed and that is very sobering. In response to queries, I asked my gp about early mammograms and was told I would not be entitled as I only have one first degree relative with breast cancer.

MissBoPeep Sat 24-Nov-12 16:59:00

I think you are absolutely right to say that you are simply replacing what would be there naturally if you took HRT up to 50-ish.

The other thing is that many of your mums ( and I really do understand having seen a friend die at 52 and leave behind a 13 year old only son) may have taken the older types of HRT such as Premarin, which are made from mares' urine.

The newer types such as gels and patches are a different kind of estrogen and if you combine these with a Mirena coil to get the protection for your uterus then you are limiting the effect of hormones in your system considerably. Women who take just oestrogen ( if they have no uterus) actually have lower breast cancer on HRT. All the stats back that up.

OP_ see a specialist who will talk to you about all the options. It's not an easy choice by any means.

MissBoPeep Sat 24-Nov-12 16:59:58

OP- you can pay for private mammograms if you wish- no need to go without if you want them.

Slinky Sun 25-Nov-12 22:50:05

I was just flicking through the Menopause section and this caught my eye as it's very close to home for me. This is my experience to date....

I have a very strong family history of BC...my mum, mum's sister, cousin and mum's aunt, all diagnosed under 50. I'm 41, and had a total hysterectomy, with ovaries preserved, back in February 2012. However, despite ovaries in place, they failed quite quickly after.

In June, my excellent Gynae recommended HRT patches, and with a lot of soul-searching on my part, and telephone calls to HRT/Breast Cancer Specialists in London on his part, I decided to opt for the patches. Immediately, he organised for me to have a mammogram done privately (hysterectomy was done privately) so that we would have a "base-line" of how my breast tissue was. The mammogram detected a lump on my right breast (obviously was there undetected by myself), so was given an ultrasound and a core biopsy. Results were a benign fibroadenoma.

5 months on, am planning to go back to GP this week to start the process of getting me onto the Mammogram screening programme. Gynae and Breast Surgeon I spoke to are both surprised I hadn't been picked up sooner.

I'm well aware of the risks I am taking and I know some people will disagree with my decision. However, the effects of my rapid descent into menopause were also quite hideous...not just the hot flushes, but I had severe decline into a depressive, almost suicidal state of mind.

thenightsky Sun 25-Nov-12 22:54:06

Recent studies show that BC risk is minimal if you start HRT early. Apparently the studies were done on women who started taking it at least 5 years AFTER menopause. Current thinking is start HRT at first symptoms of menopause and continue it as long as you want to.

MissBoPeep Sun 25-Nov-12 23:02:27

Slinky if you are able to use just oestrogen- as you have no uterus and don't need progestins- the stats show that you have a reduced risk of BC. Even the Million Women Study and the other major study which were all doom and gloom agreed on that.

It looks from the evidence so far that taking/using oestrogen alone is pretty safe and be beneficial- it's when you add in the 2nd hormone to protect the uterine lining that the cyclic activity seems to possibly afffect the breasts. But the latest study done in Denmark over 11 years shows no added risk.

You seem in good hands anyway and doing all the right htings.

MuminPinny Mon 26-Nov-12 12:18:53

Porolli - I've had mammograms on the NHS with just one first degree relative having had breast cancer (Mum age 32). Since my mum didn't have any sisters and nor do I maybe this has something to do with it as well as her very young age. You certainly have my sympathy - given my Mum's experience - I have avoided the Pill and would be very opposed to HRT which might be an issue sooner than I had thought as I may be perimenopausal at 41. That said, even my Mum (who thankfully is still alive 35 years after radical surgery) says it is worth keeping an open mind. I think I would try all other options first, rather than HRT, but if menopausal symptoms were so bad that I couldn't manage to go about daily life and look after my kids then I think that I would have to consider it. My paternal grandmother had the worst kind of osteoporosis and had an early menopause, so that would be another factor. That said my Mum had non-hormonal tablets which helped her osteoporosis which was brought on by ovarian removal and menopause at 32. In my view menopause at 41 or 42, although early, must be much better than 32. Good luck whatever you decide.

MissBoPeep Mon 26-Nov-12 15:42:13

It's worth having a look at this tie www.menopausematters.co.uk and reading some of the latest finding re. HRT and meno.

Some of the info now says that an early meno should be considered as under 47, not currently 45.

There is also some onfo about heart disease and how HRT does appear to prtect against this if taken early after meno.

Although cancer is terrible and every woman's nightmare scenario, there are in fact more female deaths through CHD than breast cancer. it's easy to focus just on cancer but heart disease is a bigger killer and women over 55/60 are at just as great a risk as men.

SnakesRule Fri 08-Mar-13 15:21:48

Menopause symptoms can be controlled with exercises and diet.It is a natural process and I cant see why anyone would want to take HRT which interferes with complex hormonal changes.How many women spend their early years on the pill, then fertility treatment in their 40th, then HRT. I am surprised there is no hormonal treatment for "puberty symptoms" yet.
It is my personal opinion, but I am really not keen on taking hormones in any form.

Bellaciao Tue 12-Mar-13 19:37:08

SnakesRule
Just to say - although this is a bit off topic - since you made the comment: if you use HRT you are not "taking hormones" as such - just replacing them (notably oestrogen) because you become deficient.

Would you not take thyroxin if you were deficient in this or insulin if you were diabetic?

All of these are "natural" conditions as is the menopause - but what is the point of suffering unnecessarily - notwithstanding all the discussion that has gone on previously?

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