One of the most common concerns for women is breast cancer. And one of the most common misconceptions is that hormone therapy is to be avoided at all costs primarily due to the Women's Health Initiative that showed an increased risk for breast cancer when using synthetic, non-bioidentical hormone therapy. However recent updated studies reveal that natural, bio-identical estrogen hormones can not only help alleviate the unpleasant symptoms of menopause, but can actually reduce the chance of getting breast cancer. In addition, studies recently have shown that using testosterone for women in menopause not only substantially improves quality of life with no adverse effects but also reduces the rate of breast cancer by up to 75%.
A major stumbling block to the use of estrogen replacement in women is the concern that it will increase the risk of breast cancer. The landmark study, The Women’s Health Initiative, was abruptly stopped in 2002 when data revealed a 26% increase incident of breast cancer in women taking the synthetic, non-bio-identical hormone Prempro. Another arm of the WHI where women were taking estrogen alone because they did not have a uteris continued. After a 13 year follow up, this arm of the study did not show any increase in breast cancer and actually revealed less breast cancer risk compared to women in the placebo group. This information is explained in more detail under the “Science” tab. Some have recommended that hormone replacement be withheld from women with increased risk of breast cancer based on personal or family history, lifestyle, increased breast density or fibrocystic breast disease, and that hormone replacement should be offered for the shortest possible time after menopause. This erroneous belief results in many women being deprived of the many benefits of natural hormone replacement therapy that may extend the functional lives of women for many years.
Research on the incidence of breast cancer in estrogen replacement therapy has offered uncertain conclusions in the past. Some studies have implicated non-human identical estrogen as one cause of breast cancer. Other studies have demonstrated increased risk when progestins which are synthetic, non-bio-identical progesterones, are given with the estrogen.
A large French study, released in 2007, demonstrated NO increase in breast cancer incidence when human bio-identical progesterone was given with estrogen. A very recent study from the Women’s Health Initiative revealed a REDUCED Incidence of breast cancer in women given estrogens for 5.9 years, with that lower rate of 21% persisting over more than 13 years of follow-up.
A paper in the American Journal Journal of Obstetrics and Gynecology Evaluated numerous other studies and found that estrogen replacement therapy after diagnosis and treatment of breast cancer did not increase-- nor reduce-- the rate of recurrence. (AJOG, August 2002, Volume 187, No.2)
In addition, evidence exists that Androgens such as testosterone is breast protective and that testosterone therapy treats many symptoms of hormone deficiency in both pre-and postmenopausal patients. The following study investigated the natural incidence of breast cancer in women presenting with symptoms of hormonal deficiency and imbalance who were treated with subcutaneous testosterone pellet implants compared to the natural historical control of breast cancer frequency incidence in the general population.
The natural history of the incidence of breast cancer in women who have never taken any hormones were studied in several very large studies that indicate the natural incidence of breast cancer is between 300- 400 cases of breast cancer per 100,000 person-years. Testosterone delivered as a subcutaneous pellet implant reduced the natural incidence of breast cancer in pre-and postmenopausal women from the previously established average incidence of 350 cases per 100,000 persons-years to 73 cases per 100,000 person-years which revealed a significant reduction, over 75%, in the natural or expected incidence/risk of breast cancer in those treated with testosterone implants.
Another article reports a rapid response of a breast cancer tumor to a combination of Testosterone-Anastrozole therapy. The article outlines the response of the breast cancer tumor volume before and after the implantation of three testosterone implants with anastrozole there were placed around a 2.5 cm breast cancer tumor followed by an additional three testosterone implants placed 48 hours later. By day 46 there was a seven-fold or 700% reduction in the size of the breast cancer tumor and volume. By week 13, there was a documented twelve-fold or 1200% reduction in the size of the breast cancer tumor volume!
Testosterone pellet therapy does not have the same risk of breast cancer as does the synthetic progestins or the oral synthetic methyltestosterone. In fact, studies show a reduction in the incidence of breast cancer with the implantation of testosterone pellets, with or without estradiol pellets (Dimitrakakis,2004, Tutera 2009). Even after 20 years of therapy with hormone implants, the risk of breast cancer is not increased (Gambrel 2006). In addition, even in studies performed with breast cancer survivors, hormone replacement therapy with pellet implantation does not increase the risk of cancer recurrence or death as does oral estrogen in combination with the synthetic progestins (Habits Trial 2004).
One study evaluating 70 women suffering from menopausal symptoms and personally having a history of breast cancer were treated with testosterone pellets inserted under the skin with local anesthesia and followed for nine years. This study was presented at the 2010 Breast Cancer Symposium (Abstract 221 by Rebecca L Glaser, M.D., FACS). None of the women had recurrence of breast cancer with use of the testosterone pellet along with an aromatase inhibitor after being followed for nine years. This is opposed to conventional therapy which reports anywhere from a 2-90% recurrence rate.This means that even if you have had breast cancer and are dealing with the symptoms associated with menopause and aging, testosterone may still remain an option. You can improve your quality of life, improve symptoms associated with menopause, and lower your risk of breast cancer recurrence.
Every woman has unique sets of needs, circumstances, and risks. We believe that hormone replacement therapy may be carefully initiated in most post-menopausal women, using low effective doses, and maintained indefinitely, provided the women are adequately informed and closely monitored, and the benefits clearly continue to outweigh the risks. The multiple benefits of hormone replacement are too substantial to be denied to the majority of women.
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