As I sit down to compose this post on Breast Cancer and hormone replacement therapy, I have a lot of thoughts swimming around in my mind about the women I know, women who are close to me and whom I care deeply about. Women with whom I have a long history and many years of experiences and memories. I am thinking about my 49-year-old sister, Amy, and my 23 year-old daughter-in-law, Shirese, my 75-year-old mom, Peg and my 63-year-old wife, Mary.
Any one of the wonderful, loving and beautiful women in my life has a 12% risk of developing breast cancer throughout her lifetime. I am thanking God that none of them have been diagnosed with breast cancer and I pray that none of them will.
If I were to add four people to the list, maybe my sisters-in-law, Carolyn and Keven, and Mary’s two close friends, Jody and Terri, the statistics say that one of these eight women is likely to be diagnosed with breast cancer at some point in their lives.
That’s one woman out of eight that could get breast cancer.
Terri was diagnosed with breast cancer in 2013, the day before her youngest son’s wedding. Mary went to most of Terri’s appointments with her and held her hand while the doctor told her about the diagnosis. Terri’s doctor recommended a radical mastectomy, since the cancer had spread to her lymph nodes. Mary was there for her friend when she had the surgery and visited her in the hospital every day. Mary walked with Terri through months of chemotherapy and radiation. Terri lost her hair, her strength and had to be on oxygen for a long time because the chemo had caused damage to her lungs.
Two years after her diagnosis, Terri is cancer free so far! She believes in the power of prayer and had some really great healthcare professionals taking care of her, along with a deeply caring community of wonderful, loving friends like Mary to support and encourage her.
Terri is not just a statistic. She’s a real woman who has had dinner at our house and ridden in our car and invited us to her son’s wedding. But she’s also the one person out of eight who has battled breast cancer and, thankfully, is winning. She represents the one woman in your life out of you and seven others that could be called on to stand up against cancer and fight . . . to the death.
Terri also represents the women who beat breast cancer. 25% of patients diagnosed with advanced cancers like Terri’s survive past 5 years. Up to 95% of those whose cancers are detected early, before they spread, live cancer free after 5 years.
The risk of dying from breast cancer, according to The American Cancer Society is about 1 in 36 or 3%. That risk has actually decreased over the past couple of decades because of advances in treatment and the decline in breast cancer incidence.
If you read headlines you may be tempted to assume that hormones CAUSE breast cancer. However, an understanding of hormones and breast cancer clears up that assumption:
Every woman older than the age of puberty and younger than the age of menopause has a cocktail of hormones in her bloodstream that includes estrogen, progesterone, testosterone and dozens of others. If hormones CAUSED breast cancer, the incidence of breast cancer would be near 100%. The incidence of breast cancer actually increases after those hormones decrease at menopause.
Studies which show an increase in breast cancer in patients who receive hormones to treat menopause must be carefully evaluated based on the simple principle that correlation does not equal causation.
The main reason people believe “hormones cause breast cancer” is something called the Women’s Health Initiative study.
In that study, there was a very slightly increased risk of breast cancer that works out to about 0.08% for each year patients took hormone replacement. [1. Writing Group for the Women’s health Initiative Investigators: Risks and benefits of estrogen plus progestin in healthy menopausal women. Principal results from the Women’s Health Initiative randomized controlled trial. JAMA 2002:288:321-333]
According to the Women’s Health Initiative, a woman taking traditional hormone replacement for 10 years has a risk of breast cancer that is 0.8% higher than a woman not taking hormones.
Some crucial things to remember about the Women’s Health Initiative study and the conclusions about breast cancer risk are:
- The combination of hormones used in the study (conjugated estrogens from horse urine and medroxyprogesterone) is much less clean and desirable than the specific hormones naturally produced by the body.
- The increased rate of breast cancer noted in the study is about the same as the increase for women who drink a glass of wine or two each day or are a bit overweight.
I will be creating content on estrogens and progesterone to explain more about these vital and misunderstood hormones.
If you are a menopausal woman – or a woman of any age, get mammograms as frequently as your doctor recommends. Know your risks. And recognize that estrogen and progesterone play a complex and necessary role in your overall health.