About this episode
Apr 23
S4 Ep200: Perimenopause Problems-an Experts Approach with Dr. Steven Goldstein
During my hiatus, please join me on Substack for written content and Substack Lives (also available on replay) Go to substack.com and download the APP FREE subscribers get access to most content and Subtack LIVEs PAID subscribers get access to all content, and can attend the mont ... Show More
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What we're talking about it this episode!
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1h 4m
There continues to be great confusion regarding the impact of hormone therapy on the breast. And despite the known benefits of hormone therapy, and reassuring data regarding the impact of hormone therapy on breast cancer, most clinicians are still reluctant to prescribe it, and most women are reluctant to take it. Even more so if a woman is high risk for breast cancer or has a breast cancer diagnosis.
In this episode, I am joined by Dr. Corinne Menn, a board-certified Ob GYN and menopause expert who herself had a breast cancer diagnosis when she was in her 20s. We will be reviewing the latest research on the impact of estrogen on the breast in several different scenarios.
- PREGNANCY post breast cancer
- Women who have a BREAST CANCER diagnosis
- Women with a FAMILY HISTORY of breast cancer
- Women with a BRCA MUTATION after prophylactic ovary removal
- The approach to therapy for women with a NEW BREAST CANCER DIAGNOSIS
- The use of local vaginal estrogen in women with a breast cancer diagnosis that are taking TAMOXIFEN or using an AROMOTASE INHIBITOR
- If a LOCAL VAGINAL ESTROGEN needs to be used at the lowest dose
- What to do if your DOCTOR NOT WILLING to prescribe local or systemic estrogen (list of articles to share is below)
- If a woman with a breast cancer diagnosis can use TESTOSTERONE for libido and other possible benefits
- Bluming AZ, Hodis HN, Langer RD. 'Tis but a scratch: a critical review of the Women's Health Initiative evidence associating menopausal hormone therapy with the risk of breast cancer. Menopause. 2023 Dec 1;30(12):1241-1245.
- Bluming AZ. Introduction: Estrogen Reconsidered: Exploring the Evidence for Estrogen's Benefits and Risks. Cancer J. 2022 May-Jun 01;28(3):157-162.
- Hodis HN, Sarrel PM. Menopausal hormone therapy and breast cancer: what is the evidence from randomized trials? Climacteric 2018;21:521–8.
- Levy B, Simon JA. A Contemporary View of Menopausal Hormone Therapy. Obstet Gynecol. 2024 Mar 14.
- Chlebowski RT, Aragaki AK, Pan K, Mortimer JE, Johnson KC, Wactawski-Wende J, LeBoff MS, Lavasani S, Lane D, Nelson RA, Manson JE. Randomized trials of estrogen-alone and breast cancer incidence: a meta-analysis. Breast Cancer Res Treat. 2024 Apr 23. doi: 10.1007/s10549-024-07307-9.
- Pan K, Lavasani S, Aragaki AK, Chlebowski RT. Estrogen therapy and breast cancer in randomized clinical trials: a narrative review. Menopause. 2022 Sep 1;29(9):1086-1092.
Use of Hormone Therapy in Women with a Breast Cancer Diagnosis
- Bluming A. Hormone replacement therapy after breast cancer: it is time. Cancer J 2022;28:183–90.
- Bluming AZ. Safety of systemic hormone replacement therapy in breast cancer survivors. Breast Cancer Res Treat. 2022 Feb;191(3):685-686. doi: 10.1007/s10549-021-06479-y.
- Fahlén M, Fornander T, Johansson H, Johansson U, Rutqvist LE, Wilking N, von Schoultz E. Hormone replacement therapy after breast cancer: 10 year follow up of the Stockholm randomised trial. Eur J Cancer. 2013 Jan;49(1):52-9.
- Mikkola TS, Savolainen-Peltonen H, Tuomikoski P, Hoti F, Vattulainen P, Gissler M, et al. Reduced risk of breast cancer mortality in women using postmenopausal hormone therapy: a Finnish nationwide comparative study. Menopause 2016;23:1199–203
Hormone Therapy in Women with BRCA Mutation
Kotsopoulos J, Gronwald J, Karlan BY, Huzarski T, Tung N, Moller P, Armel S, Lynch HT, Senter L, Eisen A, Singer CF, Foulkes WD, Jacobson MR, Sun P, Lubinski J, Narod SA; Hereditary Breast Cancer Clinical Study Group. Hormone Replacement Therapy After Oophorectomy and Breast Cancer Risk Among BRCA1 Mutation Carriers. JAMA Oncol. 2018 Aug 1;4(8):1059-1065..
Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, and the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause. She is a certified menopause practitioner of the North American Menopause Society.
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Books by Lauren Streicher, MD
Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain
Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat
Sex Rx- Hormones, Health, and Your Best Sex Ever
The Essential Guide to Hysterectomy
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