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

Dr. Corrine Menn
https://drmenn.com/
@drmennobgyn

For more information:

Episode 124 All Hormones Are Not Created Equal with Dr. James Simon

Episode 65- The Dilemma of Menopause and Breast Cancer

Episode 31 The TRUTH About Hormone Therapy: Does it CAUSE or Does it PREVENT Breast Cancer?

Episode 28: The BEST approach for BREAST Cancer Screening and Risk Reduction with Dr. Lisa Larkin

Dr. Streicher’s Inside Information podcast is not intended to replace medical advice and should be used to supplement, not replace, care by your personal health care clinician. Dr. Streicher disclaims liability for any medical outcomes that may occur because of applying methods suggested or discussed in this podcast.

Scientific Articles

Hormone Therapy and Risk of Breast Cancer

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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Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine.

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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

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

S3 Ep133: Best Breast Advice When it com...