Hormone Replacement Therapy After Oophorectomy and Breast Cancer Risk Among <i>BRCA1</i> Mutation Carriers

Kotsopoulos, Joanne; Gronwald, Jacek; Karlan, Beth Y.; Huzarski, Tomasz; Tung, Nadine; Møller, Pål; Armel, Susan; Lynch, Henry T.; Senter, Leigha; Eisen, Andrea; Singer, Christian F.; Foulkes, William D.; Jacobson, Michelle; Sun, Ping; Lubiński, Jan; Narod, Steven A.

doi:10.1001/jamaoncol.2018.0211

Cited by 141 publications

(121 citation statements)

References 42 publications

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“…Another study, which spanned 7.6 years, showed that there was no increased risk in future breast cancer development in BRCA1 carriers, post‐oophorectomy, who were using HRT compared to non‐users. This further confirms that estrogen replacement does not increase the risk of breast cancer, even among high‐risk populations …”

Section: Safety Of Hormone Replacementsupporting

confidence: 72%

The role of bioidentical hormone replacement therapy in anti‐aging medicine: a review of the literature

et al. 2019

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The changes in skin and overall appearance that occur with increasing age can be partly attributed to declining hormone levels. While hormonal deficiencies are most commonly associated with postmenopausal females, males are also subject to age-related testosterone decline and may benefit from replacement of deficient hormones. However, great disparities exist between the recommendations of scientific societies and actual use of hormone supplements in aging patients. The purpose of this literature review is to discuss the role of hormones in the aging process of the skin, explain the safety profile of hormone replacement therapy, specifically discussing the superiority of bioidentical hormones, and highlight the benefits of hormone replacement in anti-aging of the skin. In summary, this literature review suggests that hormone replacement with bioidentical hormones is a safe and effective way to prevent skin aging.

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Section: Safety Of Hormone Replacementsupporting

confidence: 72%

The role of bioidentical hormone replacement therapy in anti‐aging medicine: a review of the literature

et al. 2019

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“…The use of estrogen-only MHT appeared protective in women with a previous hysterectomy; with a notable, but not statistically significant, 8% reduction in breast cancer per year of use. 138 These findings are consistent with the overall reduction in breast cancer seen in the estrogen-only arm of the WHI; in addition, they may sway patients and providers toward consideration of hysterectomy at the time of RRSO to allow for estrogen-only MHT postoperatively.…”

Section: The Role Of Mht In Women At Risk Of Developing Breast and Ovsupporting

confidence: 68%

The role of menopausal hormone therapy in women with or at risk of ovarian and breast cancers: Misconceptions and current directions

Temkin

Mallen

Bellavance

et al. 2018

Cancer

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For women who are candidates for menopausal hormone therapy (MHT), estrogen can provide relief from symptomatic menopause, decrease rates of chronic illnesses, and improve health‐related quality of life. However, confusion surrounds the evidence regarding the impact of exogenous estrogen and progesterone on the breast and ovary. Available data regarding the risks of MHT (estrogen and/or progestin) related to the development of breast and ovarian cancer are often inconsistent or incomplete. Modern molecular and genetic techniques have improved our understanding of the heterogeneity of breast and ovarian cancer. This enhanced understanding of the disease has impacted our understanding of carcinogenesis. Treatment options have evolved to be more targeted toward hormonal therapy for certain subtypes of disease, whereas cytotoxic chemotherapy remains the standard for other histological and molecular subtypes. The role of MHT in the breast and ovarian cancer survivor, as well as women who are at high risk for the development of hereditary breast and ovarian cancer, remains controversial despite evidence that this treatment can improve quality of life and survival outcomes. Through this article, we examine the evidence for and against the use of MHT with a focus on women who have or are at high risk for breast and ovarian cancer.

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“…The strength of this study is its prospective design. Many of the biases identified in previous reports were addressed [7,9,17,18]. We avoided cancer testing-induced bias by starting follow-up after mutation testing.…”

Section: Discussionmentioning

confidence: 99%

Risk-reducing salpingo-oophorectomy, natural menopause, and breast cancer risk: an international prospective cohort of BRCA1 and BRCA2 mutation carriers

et al. 2020

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Background: The effect of risk-reducing salpingo-oophorectomy (RRSO) on breast cancer risk for BRCA1 and BRCA2 mutation carriers is uncertain. Retrospective analyses have suggested a protective effect but may be substantially biased. Prospective studies have had limited power, particularly for BRCA2 mutation carriers. Further, previous studies have not considered the effect of RRSO in the context of natural menopause.Methods: A multi-centre prospective cohort of 2272 BRCA1 and 1605 BRCA2 mutation carriers was followed for a mean of 5.4 and 4.9 years, respectively; 426 women developed incident breast cancer. RRSO was modelled as a time-dependent covariate in Cox regression, and its effect assessed in premenopausal and postmenopausal women. Results: There was no association between RRSO and breast cancer for BRCA1 (HR = 1.23; 95% CI 0.94-1.61) or BRCA2 (HR = 0.88; 95% CI 0.62-1.24) mutation carriers. For BRCA2 mutation carriers, HRs were 0.68 (95% CI 0.40-1.15) and 1.07 (95% CI 0.69-1.64) for RRSO carried out before or after age 45 years, respectively. The HR for BRCA2 mutation carriers decreased with increasing time since RRSO (HR = 0.51; 95% CI 0.26-0.99 for 5 years or longer after RRSO). Estimates for premenopausal women were similar.

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Hormone Replacement Therapy After Oophorectomy and Breast Cancer Risk Among BRCA1 Mutation Carriers

Cited by 141 publications

References 42 publications

The role of bioidentical hormone replacement therapy in anti‐aging medicine: a review of the literature

The role of bioidentical hormone replacement therapy in anti‐aging medicine: a review of the literature

The role of menopausal hormone therapy in women with or at risk of ovarian and breast cancers: Misconceptions and current directions

Risk-reducing salpingo-oophorectomy, natural menopause, and breast cancer risk: an international prospective cohort of BRCA1 and BRCA2 mutation carriers

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