Hormone Replacement Therapy in women with breast cancer that is ER/PR HER2 negative

[peace08]

What is the recommendation for women in their early 50's, who have had ER/PR HER2 negative breast cancer, stage I, no spread to lymph nodes (surgery, followed by radiation and chemotherapy) in regards to hormone replacement therapy due to complete hysterectomy resulting in severe menopause reactions?

[PaulMD]

Hi there.

Theoretically, hormone replacement should not affect patients whose tumors are hormone receptors (ER/PR) negative.  However, I myself have reservations about giving hormone replacements to cancer patients since even though the receptors are reported negative, the tumors may still harbor small amounts of ER/PR receptors below assay levels.  This may cause stimulation of cancer cells and might lead to recurrence, however, there are no verifiable studies regarding this.  I suggest you discuss this more with your oncologist but I will be not surprised if he or she will be hesitant as well.  Regards and God bless.

[mamaboulet]

I realize that some women do have very uncomfortable menopause symptoms, but I would like to inject that menopause is a natural process and life stage, and there are ways to transition through the symptoms without using HRT, which, as the doctor pointed out, is a dubious choice even for ER/PR negative cancer patients. You might want to look into some safer alternatives for your symptoms.

[peace08]

I forgot to mention that I have had bi-lateral masectomies following a 2nd breast cancer (2007) also ER/PR negative.  Since I have no breasts, ovaries or uterus, would this make a difference in your recommendation? I am also dealing with osteopenia.   I posted a more informative question.

Thanks so much for your response!

[mamaboulet]

HRT has not proven to help osteoporosis (diet and exercise are the ticket for that), and has risks for stroke and heart attack. Have you checked out alternatives for your menopause symptoms?