I can’t believe I just wrote that title.
I am NOT an oncologist, and so you need to review this with your doctor if you have BRCA. But I am reading this book about estrogen, and there are pages on BRCA patients going on estrogen replacement.
What the what ?!?
BRCA gene puts you at an increased risk for ovarian and breast cancer. And the rates of cancer are huge- 50-80% kind of huge. Women take out their ovaries to get rid of them, and the fact you don’t have an estrogen making machine (your ovaries are now gone) is thought to lower the risk for breast cancer.
So in this book, he talks about a “stunning and counterintuitive discovery” made by an epidemiologist at UPenn. BRCA patients were on hormone replacement. They looked at 462 pre and post menopausal women with BRCA mutations. They compared those on hormones for a few years after ovary removal vs. those who never did hormones. There was no increased risk of breast cancer.
In an even crazier study which showed a ? benefit to hormone replacement in BRCA patients, a medical oncologist studied 472 patients with BRCA 1 who were postmenopausal. “Among postmenopausal women with a BRCA 1 mutation, estrogen use, which averaged around 4 years was not associated with an increased risk of breast cancer; indeed, in this population it was associated with a significant decreased risk.” This study was replicated in 2016 in Toronto.
WHAT?
I needed to research more. So I went onto PubMed, and sure enough, there are many recent articles on this subject. One of the top ones listed was a Metaanalysis from 2018, concluding “HRT use after RRSO in BRCA 1 and BRCA2 mutation carriers does not affect breast cancer risk. Comparison of the different hormone replacement therapy types suggests that estrogen alone should be related to lowest breast cancer risk.”
To see more studies, visit PubMed’s library of BRCA HRT articles.
The more I read, the more complex this whole issue feels.
How did we end up thinking HRT was SO bad? They state the original disruptor was a study in Sweden which showed a 440% increased risk of breast cancer in those who took hormone replacement. It was a study of 23,000 women, which is a good sized study. But when they did the analysis, they took a random sample of 638 patients and extrapolated that data, which showed 10 cancers where 2.2 were expected. This sampling was too small and prone to error. The result was not statistically significant. But the study got published in the New England Journal, and the shocking “440% increased risk” repeated in the media without adequate background. Then came the Women’s Health Initiative, and chaos ensued.
See my blogs on the WHI study, which was aborted due to the claim hormone replacement caused significant issues with breast cancer and heart risk. Since then, the data has been reanalyzed, as many issues were found with the initial reporting in 2002.