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ABSTRACTHormone replacement therapy (HRT) may increase the risk of breast cancer (BC) in post-menopausal women. Due to cessation of menstrual blood, an increased iron level is one of the most important physiological changes in post-menopausal women. We postulate that HRT together with high iron in post-menopausal women may lead to increased risk of BC. We have tested this hypothesis in cell culture models with different status of estrogen and progesterone receptors as well as an iron loaded transgenic mouse model. Our results have shown that Prempro, the most prescribed HRT drug, have induced cell proliferation only in estrogen receptor positive cells and estrogen is the main active component in the drug for the proliferation. Estrogen also induced transferrin receptor, a membrane protein controlling iron uptake. In animal study, female wild type and iron overloaded HFE homozygote mice were inoculated with mouse mammary cancer cells into the fat pads and then fed a diet with or without Prempro. No significant differences in tumor incidence were observed among mice. In conclusion, our hypothesis was confirmed in an in vitro tissue culture system. However, animal study failed to produce mammary tumors in our proposed iron overloaded transgenic mice.