Women are terrified of HRT, as they fear it will increase their risk of breast cancer. I know…. I was that woman!
HRT was a ‘no-no’ for me…initially. All I knew at the time were the scary newspaper headlines and urban myths. What I did not know were the facts. When I looked at the benefits and risk factors for me and looked at the chart here, which empowered me to make an informed choice, I chose fact over fiction. So I thought that in additional to this brilliant graphic (from the British Menopause Society and the Women’s Health Concern) I would also touch on some more facts about breast cancer. I have taken a lot of the information below from the Marie Keating Foundation website, which is an excellent source of information. So no need to reinvent the wheel!
Did you know
Around 3,323 women are diagnosed with breast cancer in Ireland each year. Breast cancer is the most common cancer in women in Ireland, after skin cancer. 1 in 10 women in Ireland develop breast cancer during their lifetime. It is most common in women over the age of 50, but you can get it at a younger age.
Risk Factors
Getting older is a risk factor - Like most cancers, the risk of developing breast cancer increases as women get older. As we get older the cells in our body have had more chance to make mistakes as they divide. However, it is important to get into the habit of checking your breasts monthly from the age of 20 so that you know what is normal for you and are able to spot any changes as soon as they occur. It is important to have mammograms as part of BreastCheck, the national breast screening programme. BreastCheck invites women aged 50 to 68 for a free mammogram on an area-by-area basis every two years.
Family history - If your mother, sister or daughter was diagnosed with breast cancer, particularly at a young age, you have an increased risk of breast cancer. However, it is important to note that the majority of people diagnosed with breast cancer have no family history of the disease.
Breast density is one of the strongest independent risk factors for developing breast cancer, stronger even than age or family history, with women with ‘extremely dense’ breast tissue being four-to-six times more likely to develop breast cancer compared to women with ‘mostly fatty’ breasts. High breast density can also have the effect of ‘masking’ breast cancers, as they also show up as white on a mammogram, and are thus more difficult to see. 10% of women between the ages of 40 – 74 have extremely dense breast and 35% have heterogeneously dense breast.
Breast cancer genes - Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. If you have a very strong family history, there may be a faulty gene in your family that increases your risk of breast cancer. There are probably several faulty genes but two that we know about, and can test for, are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don’t make cancer inevitable. If you have either of these genes, your risk of getting breast cancer by the age of 70 is between 45 to 65%.
Having children - Your risk is reduced if you have children, the more children you have, the younger you are having your first child
Menstruation - When you start and stop having periods. Your risk is increased by starting your periods at a younger age, if you start menopause late Both are mainly due to longer life span exposure to hormones
Alcohol intake - Drinking alcohol has been consistently linked to an increased risk of developing breast cancer. The risk increases with the amount of alcohol consumed. For example, compared with a woman who does not drink, a woman who has 1 alcoholic drink a day has a very small increased risk while a women who has 2 to 5 drinks daily has a 1.5 increased risk of breast cancer. Other cancers, such as liver cancer, colon and rectal cancer and mouth cancer, are also linked with alcohol consumption. it is best for women not to drink more than 11 units of alcohol per week. Be mindful that one drink does not equal one unit. Large wine glasses hold 250ml, which is one third of a bottle. It means there can be nearly two units or more in just one glass.
Weight - Women who are overweight after the menopause have a higher than average risk of breast cancer. This may be because women who are overweight ovulate less than average so their breast cells may be exposed to lower levels of oestrogen. But after the menopause, your oestrogen levels are linked to the amount of body fat you have. The more fat you have, the higher your oestrogen levels are likely to be. If you are apple shaped as opposed to pear shaped you are at higher risk of developing any kind of cancer. This is associated with more fat deposits around the abdomen. If you had a higher weight at birth, your risk of getting breast cancer before the menopause (pre-menopausal breast cancer) may be higher than someone who had a lower birth weight.
Height - Taller women have an increased risk of breast cancer after the menopause. It’s not clear why this is, but taller women may have more breast tissue, which might increase the risk.
Other medical conditions - Medical conditions that may increase breast cancer risk include diabetes and benign thyroid conditions.
Dietary fat - Women who have a high amount of fat in their diet have a higher risk of breast cancer than women with lower dietary fat levels. Eating higher amounts of saturated fats also increases breast cancer risk.
Shift work - Some studies have shown that women who do night shift work have a slight increase in breast cancer risk. Other studies show that sleeping longer reduces the risk of breast cancer. Some researchers think this may be because broken or shorter periods of sleep lowers levels of a hormone called melatonin.
HRT is linked to a higher risk of breast cancer. Combined HRT (oestrogen and progesterone) is more likely to cause breast cancer than oestrogen only HRT. To put the risk into numbers, if 10,000 women took oestrogen-only HRT for a year, it would result in up to about 8 more cases of breast cancer per year than if they had not taken hormone replacement therapy (HRT).
So whether you take HRT or not to help you manage your menopause, you need to also be taking care of your breast health as part of your overall menopause health.