The recent paper looking at breast cancer risk and HRT use has been portrayed in the media in an unnecessarily alarmist way.
This is not new evidence, these are old studies looking at women all over the world who have taken HRT from 1992 to 2018. Many of these studies were retrospective, observational and using outdated treatments.
There is no information here about any increased risk of dying from breast cancer. All the big studies done previously look at mortality from breast cancer and The WHI studies show no difference in cancer deaths in women who have taken HRT.
Dr Woyka comments that the lead investigator of the study, Professor Beral when interviewed this morning said she had done the study as she was worried about the upsurge in interest in HRT and she wanted women to be properly informed.
Dr Jane Woyka, Principal GP at Harrow Health Care Centre and a leading expert in the menopause, has said that the latest study from the University of Oxford published in The Lancet did not give a clear overview of the relationship between HRT and breast cancer.
Her comments chime with the advice from the British Menopause Society (BMS), of which she is a member, which has said that “the overall findings from this study are in keeping with the NICE Menopause guideline recommendations which show a small increase in the risk of breast cancer with HRT.”
The BMS has said that women “must be informed of the data on breast cancer risk with HRT to help them make an informed decision”, and point out that the study fails to consider other lifestyle factors such as alcohol intake and obesity, as well as the mortality of those diagnosed with breast cancer.
Reflecting on the findings of the study and comments from the BMS, Dr Woyka said: “Important studies from the Women’s Health Initiative, which compare mortality from breast cancer in women who have taken HRT with women who have not, show no increased risk of dying from breast cancer if you have taken HRT.
“Some progestogens are more breast friendly, there are several factors to consider when prescribing, so a one size prescribing does not fit all, but in the UK we have been using rather different progestogens in the last few years which we believe have a smaller risk in respect to breast cancer.
“We have always known that taking HRT slightly increases the risk of breast cancer after five years of use post-menopause and we use an infographic to illustrate that risk to patients so that they are fully aware.
“The numbers of women getting breast cancer because they take HRT is quoted as one extra case per 1,000 women per year. There are far more powerful risk factors influencing cancer risk than taking HRT, specifically obesity, where we see five extra cases per year of breast cancer in 1,000 women whose BMI is above 30 . We would do well to remind women of that when looking at the risks involved with HRT.”
Dr Woyka pointed out there was a wide range of different hormones researched in the Oxford University study, with most of the progestogens being different to the ones currently used in the UK that met NICE guidelines.
“This study will have panicked some patients I am sure, and to headline a doubling of risk is sensational, and irresponsible: it is actual numbers of extra cases that is important and at worst that would mean one more case per thousand women per year. We need to look at the bigger picture and the benefits that HRT can offer to those women experiencing the menopause,” she added.
“HRT provides effective symptom control and improves quality of life, as well as offering long term benefits in regards to bone and cardiovascular health.”
Dr Woyka recommended that women seek out further advice if they were concerned, but said that they should not stop HRT as there was evidence that a sudden, unplanned suspension of treatment is associated with a small but important increased risk of a stroke in the first year after stopping.
“Women undergoing HRT should continue as usual with their treatment and attend regular mammograms, as well as being breast aware. This is just one broad study amongst the hundreds already conducted and does not indicate anything conclusive about one particular therapy,” she concluded.
If you are concerned about your HRT and would like to speak to the specialists at Harrow Health Care Centre, please call 020 8861 1221 or visit www.harrowhealthcare.co.uk
