Whether or not you are on HRT it is a good idea to regularly self-examine your breasts (ideally monthly). No extra monitoring is required if you are on HRT. If you have any concerns please see your doctor/health care provider.
MYTH - There is an increased risk of breast cancer with all types of HRT
This is the risk that most women worry about with HRT. You may have a small increased risk of breast cancer if you take some types of HRT, particularly after the age of natural menopause. However, if you are taking estrogen-only HRT (so, if you have had a hysterectomy) then you may not have an increased risk of breast cancer. There are many risk factors for developing breast cancer. Women who are overweight, drink alcohol, smoke, undertake little or no exercise all have a higher risk of developing breast cancer. The increased risk of breast cancer is associated with women who take certain types of combined HRT (estrogen and a progestogen) and this risk increases the longer you take HRT for. This risk appears to be lower with some types of progestogens compared to others. When you stop taking HRT, any increased risk of breast cancer reduces.
The actual risk of breast cancer with taking combined HRT is very small. The risk is actually less than the risk of breast cancer in women who are obese and in those women who drink two to three units of alcohol each day. There is no evidence that taking HRT increases a woman’s risk of dying from breast cancer.
Note: There is no increased risk of breast cancer in women who take HRT under the age of 51 years (see later myth).
HRT is associated with a risk of breast cancer in younger women with Premature Ovarian Insufficiency (POI).
POI is when menopause occurs in women under the age of 40 years. Women with POI should be given replacement hormones either in the form of menopausal hormone therapy (HRT) or the combined oral contraceptive pill (COCP) until at least the average age of the menopause (51 years). This is not just to improve any symptoms of menopause but also to maintain their long-term health and reduce their increased risk of osteoporosis, cardiovascular, psychological, and cognitive diseases. Any risks of HRT (for example, breast cancer risk) do not apply to younger women with POI taking HRT. Taking hormones is simply replacing hormones that your body would otherwise be making up until the age of the natural menopause.
Everybody’s breasts are different – different sizes, shapes, and with various types of lumps that may come and go. What’s standard for you may not be your friend’s “normal.” Get to know the normal look and feel of your breasts by checking in with your body regularly. Look at and touch your breast tissue from multiple angles with varying pressure to feel both the deep and surface layers, from the interior by your ribs to just below the skin. Don’t forget that your breast tissue extends up your collarbone, around to your armpits, and into your breastbone.
If you notice any of these symptoms that persist or worsen for 2-3 weeks, see your doctor:
- Swelling, soreness or rash
- Warmth, redness or darkening
- Change in size or shape
- Dimpling or puckering of skin
- Itchy, scaly sore or rash on nipple
- Nipple that becomes flat or inverted
- Nipple discharge
- New, persistent pain in one spot
- Persistent itching
- Bumps that resemble bug bites
- A lump, particularly one that feels like a frozen pea
.Need reminding to do your check? There are some great services that give you a nudge once a month to check your breasts:
Coppafeel (UK) have a free text message UK reminder.
Bright Pink (US) have a reminder service.
Other countries will also offer similar services so have a search!