More Answers to Your Questions on Breast Cancer and Hormone Therapy

Dec. 18, 2006 — -- Thank you for the strong interest in participating in this Q&A with Dr. Clifford A. Hudis, the chief of breast cancer medicine service at Memorial Sloan-Kettering Cancer Center.

Your questions keep pouring in, and we can hardly keep up with them all!

Below are more answers from Hudis, in response to a selection of your questions from the "World News" message board.

To watch his interview on "World News" about the new study regarding falling breast cancer rates with respect to hormone replacement therapy, (HRT) click here.

Question: I have been taking estrogen since I was 30 and I am 51 now. I haven't had any problems with breast cancer and have mammograms every year. Should I be concerned about this and stop taking the HRT. My doctor has never been concerned about me taking the estrogen. -- grannyd54

Hudis: Every woman taking HRT will not get breast cancer. This is a risk. It is akin to wearing or not wearing seat belts while driving. Almost everyone will survive a lifetime of driving without wearing seat belts but the risk of dying in a car accident is increased. Similarly, you probably will not get breast cancer but your risk is increased. It is your tolerance for that increase in risk that should drive your decision. A final point is that most of the claimed benefits for HRT have not been confirmed in randomized trials so our bias is that you should not be on them if at all possible.

Question: I stopped taking HRT when the news came out about its increasing the risk of breast cancer. I have now noticed that having sex is uncomfortable and sometimes painful, resulting in either itching, soreness and/or abrasions. What can be done for that? -- usmbelle

Hudis: There are a variety of topical treatment options. You need to discuss this directly with your gynecologist.

Question: How could the rate of breast cancer immediately begin to drop by 1 percent per month in the Spring of 2003 (as reported by ABC News) when women just began to stop HRT per their doctors' advice? Does not it take years for breast cancer to develop as my wife pointed out to me and as happened to her? -- shneid

Hudis: Not necessarily. If there were small breast cancers fueled to grow larger by the hormones, they might immediately stop growing and shrink when the estrogen was removed. We see exactly this when we treat advanced breast cancers with hormone blocking drugs. The cancers shrink within days or weeks in many cases.

Question: My doctor wants me to use an estrogen vaginal cream. Does this carry the same risks as HRT? -- margiotta52

Hudis: We don't know. Some recent studies have documented absorption of these estrogens through the vaginal wall into the bloodstream but we don't yet know the significance. If this is the only effective option for an individual, then it should be used as sparingly as possible.