Estrogen As Risk Factor

[CeCy]

Would I be considered a high risk for breast cancer because I began to menstruate early, age ten, and because I never have been pregnant?  I began menopause early, age 43.  I took a low dosage of PremPro for six years.  I was taking it more because of my mother's severe osteoporosis than anything else.  I quit taking PremPro four months ago after having read all the medical drawbacks associated with the treatment.  I had a bone density test done two years ago, and it showed little thinning.  I repeated the test four months ago and was very surprised to be told that I had full blown osteoporosis with a T-score of -4.  Obviously, the HRT did little good for me.  I am 51 years old and in otherwise good health.  There is no history of cancer in my immediate family although I did have an aunt to die from breast cancer.  I am the only daughter in my family. I have had mammograms done yearly since age 40.  I have had callbacks practically every other year, resulting in various diagnostic mammograms and one ultrasound.  I am always told that the radiologist just needs to get a better view, etc., etc.  No bad news, though.
  Am I incorrect in thinking that my early menopause offsets my early menstruation as far as overexposure to estrogen?  Doesn't the fact that I have osteoporosis mean that my bones aren't very dense and, therefore, must not have a lot of estrogen?  I realize I am oversimplifying the role of estrogen in the possible development of breast cancer, but I am attempting to evaluate where I stand.
  Thank you very much.

[CCF-RN,MSN-rf]

Dear CeCy:  It is difficult to calculate risk for breast cancer.  You have several factors that may increase your risk - slightly.  These are second degree family member, early onset of menstruation, and not having children.  Also, as you get older, your risk increases.  This does not necessarily make you "high risk."  High risk often is an indication to screen differently or more often.  The role of estrogen in the development of breast cancer has not been fully sorted out. The best way to determine your risk is to see a genetic counselor - this is their specialist.  An alternative would be to speak with a breast specialist who can determine your risk and make appropriate recommendations.  Dr. Susan Love's breast book has a good discussion of risk - although it is too long and complicated to try to duplicate in this forum.

[surgeon]

Overall, it sounds as if your risk is about average: early menarche is a slight risk factor, as is late menopause. There's no reason to consider you high risk. Like any woman your age, you ought to have regular screening; meaning monthly self-exam, and annual mammogram and professional exam.