QUESTION: At any time, can a breast cancer survivor go on hormone replacement therapy (HRT) if diagnosed with osteoporosis but cancer free 10 + years?

ANSWER: As you can see from the lengthy menopause section of our site, the role of hormone replacement therapy after menopause for women who've had breast cancer remains controversial. The basic best approach is to try other treatments first for the various things you are looking to achieve: cholesterol reduction (diet and cholesterol-lowering drugs), heart health (above, plus blood pressure control, etc.), vaginal function (lubricants and the Estring). As for bone strengthening for osteoporosis, there are many approaches besides estrogen replacement therapy. These include exercise, calcium, vitamin D, no smoking, and limited alcohol use. Medications include: tamoxifen or raloxifene, Miacalcin (nasal calcitonin), and Fosamax (alendronate sodium). Find more details on bone health.

—Marisa Weiss, M.D.

QUESTION: Can you provide me with information and/or resources regarding hormone replacement therapy and breast cancer? How much HRT increases risk; does the number of years one takes HRT have a particular impact; besides their physician, where can women get more information on this subject?

ANSWER: Long-term use of hormone replacement therapy does increase your risk of breast cancer by approximately 30%. So if your risk were 6%, then it might increase your risk to 8% (30% of 6 = 2, then add 2 to 6 to get 8). This long-term use kicks in after about five years. Visit our menopause section to learn more.

—Marisa Weiss, M.D.

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