The Hormone Therapy That Reduces Breast Cancer Risk & More

The Hormone Balancing Act

We’ve written before about menopausal HRT:

What You Should Have Been Told About Menopause Beforehand

…and even specifically about the considerations when it comes to breast cancer risk:

Menopausal Hormone Replacement Therapy

this really does bear reading, by the way—scroll down to the bit about breast cancer risk, because it’s not a simple increased/decreased risk; it can go either way, and which way it goes will depend on various factors including your medical history and what HRT, if any, you are taking.

Hormone Modulating Therapy

Hormone modulating therapy, henceforth HMT, is something a little different.

Instead of replacing hormones, as hormone replacement therapy does, guess what hormone modulating therapy does instead? That’s right…

MHT can modulate hormones by various means, but the one we’re going to talk about today does it by blocking estrogen receptors,

Isn’t that the opposite of what we want?

You would think so, but since for many people with an increased breast cancer risk, the presence of estrogen increases that risk, which leaves menopausal (peri- or post) people in an unfortunate situation, having to choose between increased breast cancer risk (with estrogen), or osteoporosis and increased dementia risk, amongst other problems (without).

However, the key here (in fact, that’s a very good analogy) is in how the blocker works. Hormones and their receptors are like keys and locks, meaning that the wrong-shaped hormone won’t accidentally trigger it. And when the right-shaped hormone comes along, it gets activated and the message (in this case, “do estrogenic stuff here!” gets conveyed). A blocker is sufficiently similar to fit into the receptor, without being so similar as to otherwise act as the hormone.

In this case, it has been found that HMT blocking estrogen receptors was sufficient to alleviate the breast cancer risk, while also being associated with a 7% lower risk of developing Alzheimer’s disease or related dementias, with that risk reduction being even greater for some demographics depending on race and age. Black women in the 65–74 age bracket enjoyed a 24% relative risk reduction, with white women of the same age getting an 11% relative risk reduction. Black women enjoyed the same benefits after that age, whereas white women starting it at that age did not get the same benefits. The conclusion drawn from this is that it’s good to start this at 65 if relevant and practicable, especially if white, because the protective effect is strongest when gained aged 65–69.

Here’s a pop-science article that goes into the details more deeply than we have room for here:

Hormone therapy for breast cancer linked with lower dementia risk

And here’s the paper itself; we highly recommend reading at least the abstract, because it goes into the numbers in much more detail than we reasonably can here. It’s a huge cohort study of 18,808 women aged 65 years or older, so this is highly relevant data:

Alzheimer Disease and Related Dementia Following Hormone-Modulating Therapy in Patients With Breast Cancer

Want to learn more?

If you’d like a much deeper understanding of breast cancer risk management, including in the context of hormone therapy, you might like this excellent book that we reviewed recently:

The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons

Take care!