The Who, What, Where, When and Sometimes, Why.

Menopausal hormone therapy and breast cancer recurrence

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.

Introduction: Menopausal hormone therapy (MHT) increases the risk of developing breast cancer (see Table 8) [1]. For this reason, women are advised to avoid long-term use of MHT.

MHT is also known as postmenopausal hormone therapy and hormone replacement therapy.

MHT isn’t usually given to breast cancer survivors because findings from large randomized controlled trials have shown MHT use increases the risk of [2-3]:

  • Breast cancer recurrence at the original site (local recurrence)
  • Metastasis (distant recurrence)
  • Cancer in the opposite breast  

Women have other options for treating menopausal symptoms.

Learn about the strengths and weaknesses of different types of studies.  

Study selection criteria: Randomized controlled trials.

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.

Study

Study Population
(number of participants)

Follow-up
(months)

Relative Risk of a Breast Cancer Event Among Survivors Who Used MHT after Breast Cancer Compared to Those Who Did Not,
RR (95% CI)

Randomized controlled trials  

Holmberg et al. [2]

442

48

Local recurrence, metastasis or
cancer in the opposite breast:
2.2 (1.0-5.1)

Fahlén et al. [3]

378

130

Local recurrence:
0.8 (0.3-1.7)

Metastasis:
1.0 (0.5-2.3)

Cancer in the opposite breast:
3.3 (1.2-10.9)

 

References

1. Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 288(3):321-33, 2002.

2. Holmberg L, Iverson OE, Rudenstam CM, et al., for the HABITS Study Group. Increased risk of recurrence after hormone replacement therapy in breast cancer survivors. J Natl Cancer Inst. 100(7):475-82, 2008.

3. Fahlén M, Fornander T, Johansson H, et al. Hormone replacement therapy after breast cancer: 10 year follow up of the Stockholm randomised trial. Eur J Cancer. 49(1):52-9, 2013.

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