HRT and family history of breast cancer?

[SuddenlyShoesan]

I believe I’m likely in peri and have made an appointment with a GP to talk about it, which is still weeks away. My mother had breast cancer twice and I’m reading conflicting information about whether HRT is appropriate or not. I will mention this history to the GP of course but I thought I would also ask the collective wisdom of MN in preparation for when the GP calls.

If your GP is well informed then they're the person to discuss it with. Otherwise a menopause specialist who has experience in more complex cases. Do you know what kind of cancer it was? You can research the risks of HRT on cancer to be informed. It can be a risk/reward discussion, not just a blanket yes/no. You may have peri symptoms now that are causing you a lot of distress and alleviating them will allow you to be healthier and happier, so it's the theoretical risk of breast cancer versus the actual impact of peri. If you're coping well with peri and just exploring HRT options, you may think about it differently. If you can research from reliable sources, then you can be informed. Also, there only ever seems to be talk of HRT and contraception in terms of breast cancer. If you drink alcohol, don't exercise, are overweight etc. you are increasing your risk and no one ever talks about that so we're rarely making informed choices if we rely on headlines only.

If you drink alcohol, don't exercise, are overweight etc. you are increasing your risk and no one ever talks about that

Really? I think that's a well known risk for not only cancer but lots of other diseases!

Is there a history of cancer in other relatives?

Any cancer - not just breast cancer

I was given HRT even though my mother had breast cancer, partly because she was the only member of the family to have ever had it, the increased risk is very low, and I don't drink, smoke, I'm low weight, I train a huge amount, eat a very strict healthy diet etc etc.

However, other relatives in my family have had other types of cancer, while there is no history on either side of either osteoporosis or heart disease, and all the while I was on it I was extremely anxious about the elevated cancer risk, despite its being very low. I'm in peri, and the worry on HRT was proving worse than my symptoms, so I stopped taking it and feel much better.

That might change, but as someone upthread said it really is a matter of assessing and balancing risks and rewards.

I have other family members who had breast cancer and am considered at heightened risk for it, and my GP wouldn't prescribe HRT. My sister saw a specialist who also advised against it, however I was told that if it had been just our mother, and her cancer had been diagnosed as an older woman, there would have been no problem, as breast cancer is so common in older women. So it will depend on your personal circumstances.

Regarding other cancer types in the family, my mother also had colon cancer, and my father had prostate cancer.

I don’t drink or smoke but I am overweight (not obese). I need to lose around 15 pounds. I do get daily exercise however and my diet is pretty good.

I’m wondering if it’s worth it or I should just ride out the peri unless it becomes unbearable.

I was told the same thing - my mother was the only family member to have it and she was diagnosed in her 70s, so no doctor thought it was much of an issue. But for me the mental stress proved too much, which surprised me, but then again this was very soon after her death.

I was told no, but with two close relatives with breast cancer and one with another type of cancer - I wasn’t surprised. Have just ridden the symptoms out as best I can 🤷🏻‍♀️I think, like a PP, taking it would have just made me more stressed.

My mother had breast cancer when she was over 50 and I take HRT.

I take the lowest dose available. I don't smoke or drink alcohol and I maintain a healthy weight and I am very physically active. I do my regular mammograms.

I was diagnosed with osteoporosis when I was in my 40s, so this is one of the reasons why I take HRT.

I’ve had breast cancer and a full hysterectomy so medical menopause and I take HRT. I’ve had specialist advice from an NHS menopause clinic, I’ve seen Nick Panay privately and I’m back under my breast oncologist to make sure I get annual screening. There are risk, this is how I manage them with being able to hold down a career and not kill someone with the rage I felt without HRT, I also couldn’t sleep at all without it and so this is my balance. Seek specialist advice, your GP may not want to make this call.

I do worry about osteoporosis, but was advised that the best way to avoid this was to eat a good diet, keep generally fit and to walk just a mile or two every day, to maintain the strength of the leg bones, which are most likely to fracture. This was from a GP with a particular interest in HRT and breast cancer, due to her own circumstances.

Did you have primary BC? Are you having to take hormone blockers ( I'm guessing not if you are on HRT?)

I've had primary and now secondary BC and a hysterectomy. The rage is off the scale. I feel sure I will kill someone soon! No idea what to do.

Primary breast cancer in my late 20s, both oestrogen and progesterone positive grade 2, treated with lumpectomy, chemo and radiotherapy, no risk factors or family history. Fully hysterectomy for degraded fibroids when 41, which they thought might be cancer but thankfully weren’t. The rage was horrific and with the full consent of my oncologist we agreed on oestragel and testosterone with vaginal oestrogen too.
Natural things that helped, cutting sugar, long walks, yoga, I take collagen for joint pain and I also take Elle McPherson s welleco super greens elixir. Apart from the collagen which I am evangelical about (I know some people say it’s hokum) the main benefit and help is from my HRT. I’m sorry to say this as I know it’s not what you want to hear. See a specialist - if you can afford Nick Panay he’s excellent (albeit I didn’t like him personally).

@Summerdew yes I saw a member of Nick Panays team back in 2019, when meno first hit me. I was prescribed gel, testosterone and progesterone and it was great.

Hysterectomy last year for sarcoma, followed by a hormone driven secondary breast cancer diagnosis. That was it, HRT taken away instantly.

The most the oncologist is willing to green light, is vagifem and maybe a localised oestrogen cream.

It's no way to live.

I went through menopause with a few niggles but it was bearable. Whilst I welcome more open discussions on the menopause for some HRT is just not needed. No history of cancer in my family, heart attacks kill a few off but most live to great ages and I mean close to 100.

No it’s no way to live I agree. Three people I’ve come across in my own research with various allegations of being quacks are Dr Mindy Peltz who has a menopause guide, Dr Simone L something (worked on welleco and seems sensible) and Dr Marion Stewart, all have various hints and tips for managing naturally, although with all natural remedies the costs go through the roof. I really hope you find a way that works for you or you can negotiate with a specialist.
And I agree not everyone does need HRT, but those of us who do should get support, not fobbed off with oh sorry you’re high risk so no.

I'm high risk for breast cancer and have annual checks at Barts Family History Clinic (for the last 20+ years). My mother had breast cancer 3 times and finally died from it at age 51. Her sister (so my aunt) also died from it in her late 50s. I can't been tested for the gene as they both died before gene testing became a thing.

Peri hit me really badly a few years ago. I have long Covid and didn't realise initially that it was peri making it even worse. I was refused HRT because of my family history but got a referral to a NHS menopause clinic (after battling with my GP). I was also on the waiting list to see Nick Panay privately. The NHS menopause clinic liaised with my breast cancer specialist (who said no to HRT at first). Eventually it was agreed that my peri symptoms were so bad and were impacting my ability to hold down a job that if I chose to accept the increased risk, they would prescribe me HRT. I take Oestrogel and Utrogestan as these are considered the lowest risk for my circumstances. Of course there is still a risk but I'm 54 now so already 3 years older than my mother was when she died so I see every extra year as a bonus. The HRT has really helped me and I'm functioning well at work again (was recently promoted) despite the sodding long Covid. If I develop breast cancer, I will face it. Before I made my final decision, I discussed it at length with my father. My biggest fear was actually putting him through the experience of his only child having breast cancer after living through so many years with my mother having it and finally losing her.

OP, you will do what is right for you, in your current situation. I'm a firm believer in quality of quantity of life.

You could suffer years of being miserable with debilitating peri symptoms, or bite the bullet and seek help.

My menopause symptoms hit me hard, 10 years post primary hormone BC. After lengthy discussions with oncology and menopause specialists, it was agreed I could have HRT.

Fast forward and the cancer has returned as incurable. But my lovely gynae surgeon said " have no regrets taking HRT, it gave you quality of life" She was right.

I know people who have had BC, and never taken HRT, yet it still returned. It doesn't discriminate.

Don't suffer OP, not when you don't need to.

My mother has breast cancer in her 60s, which is one reason I have never considered HRT. But the main reason is that (luckily) I never felt I needed it.

I checked the age of my mother’s initial breast cancer and colon cancer, she was early 60s.

I meant in terms of day to day life. If you talk about HRT with friends or family someone will pipe up straight away with the breast cancer risk. But when people chat about their weekends and say they were out for a few drinks no one says 'oh aren't you worried about getting breast cancer?'. So it comes up all the time with HRT in a way that makes it seem like a larger risk. There was a great newsletter recently from Dr Gunter about all these scare headlines that popped up about the risk of cancer with certain contraception (including coil which can be used as part of a HRT regime) and she pointed out that pregnancy actually brings a larger cancer risk and no one ever mentions it! So my point was to inform yourself on true risks and not to fall into the trap of what headlines or other people will make you worried about.

My mother had breast cancer and I have suffered a stroke in my early 40’s (due to a sports accident). I’m not over weight, hardly drink and exercise very regularly.

Because of cancer in my family & the stroke I’ve had (which I’m fully recovered from) I am considered high risk.

I’m on a low dose of HRT (it was actually encouraged by my GP) and it’s been life changing! The sleep deprivation was killing me before!

I do have my blood pressure taken when I ask for a repeat prescription.

@ThereTheyGo I know what you mean. My GP told me that despite my increased risk due to my family history, being overweight would put me at a higher risk.

OP@SuddenlyShoesan it is unlikely that your mums breast cancer will confer any extra risk for you taking hrt…by “ family history” they are looking for other patterns such as eg.breast/ ovarian cancer before a certain age or multiple family members with certain cancers. Indeed many of us will have at least 1 family member that develops breast cancer seeing as it affects 1 in 7 women. only 10% of breast cancers have a genetic/familial link. These links explain a little more https://www.themenopausecharity.org/2021/10/21/family-history-of-breast-cancer-should-i-take-hrt/

healthinmenopause.co.uk/breast-cancer-in-the-family-your-menopause-questions-answered/

There is some helpful advice on here.
I have a family history of breast and womb cancer, albeit women in later life.
As soon as my DM and Aunt were diagnosed with BC (both in the same year, aged 71 and 73) we were referred to Addenbrookes for genetic screening (thankfully negative.) I was also referred to our local BC family risk programme. This means I get a yearly mammogram and consultation with a specialist. Try to get on your local programme. They have been a helpful person for me and my GP to discuss HRT risks with and GP was happy to prescribe HRT, with consultant's support. It's been life changing,