A useful article published in “Menopause” has reviewed current information on the effect on breast cancer risk with the use of HRT after removal of ovaries for risk reducing surgery in women who carry the BRCA gene.
BRCA1 gene is associated with risk of breast cancer by age 70 of 60% to 65% and of ovarian cancer of 39% to 59%. BRCA2 gene is associated with risk of breast cancer by age 70 of 45% to 55% and of ovarian cancer of 11% to 17%.
It is known that removal of both ovaries and Fallopian tubes in premenopausal women reduces ovarian, fallopian tube and peritoneal cancer risks by 72% to 80%, and reduces breast cancer risks by 46% to 48% in these women. However, it is also known that early or premature menopause which ensues can cause significant menopausal symptoms and detrimental effects on bone, heart and brain health.
The article explains that studies so far have shown that the risk of breast cancer is not increased with the use of HRT after risk reducing surgery and that young women should not avoid risk reducing surgery because of fear of need for and effect of HRT thereafter. However, studies are limited and further research is required.
Reference:Use of Systemic Hormone Therapy in BRCA Mutation Carriers. Domchek S, Kaunitz A M. Menopause 2016;23(9):1026-1027