Breast Tenderness in Women on HRT May Be a Warning Sign . . .

Although hormone replacement therapy (HRT) has declined in use in the last decade, there are still a number of women whose menopausal symptoms are so severe that HRT is required.  Some women experience breast tenderness after starting HRT, and researchers have analyzed data from the Women’s Health Initiative trial to see if there’s a relationship between such tenderness and breast cancer.  Their findings are published in the Archives of Internal Medicine.

The trial randomly assigned postmenopausal women to take conjugated equine estrogens plus medroprogesterone, or placebo.  The trial was halted when it was found that those taking the estrogen-progesterone combination were more likely to develop breast cancer.  At baseline and annually, the women were examined for self-reported breast tenderness.  The average follow-up period was 5½ years.

Data were available from over 16,000 women in the study.  There were 14,538 of them who had no breast tenderness at baseline.  Significantly more of those assigned to take the HRT experienced new-onset breast tenderness after 12 months in the study – 36.1% vs. 11.8% of placebo subjects.  And of those in the HRT group who had breast tenderness, breast cancer was significantly more likely in those with breast tenderness than in those without tenderness; 48% more likely, in fact.  In the placebo group, breast cancer was not linked to new-onset breast tenderness.

Roughly ¾ of breast cancers are estrogen-receptor positive, meaning they are ‘fed’ by estrogen.  Perhaps HRT causes breast-tissue cells to multiply more rapidly, producing tenderness.  At all events, doctors are urged to prescribe the lowest dose for the shortest time possible.