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NICE guidance - HRT and breast cancer risk

Authoring team

Breast cancer risk and HRT

  • the baseline risk of breast cancer for women around menopausal age varies from one woman to another according to the presence of underlying risk factors

  • HRT with oestrogen alone is associated with little or no change in the risk of breast cancer

  • HRT with oestrogen and progestogen can be associated with an increase in the risk of breast cancer

  • any increase in the risk of breast cancer is related to treatment duration and reduces after stopping HRT

Absolute rates of breast cancer for different types of HRT compared with no HRT (or placebo), different durations of HRT use and time since stopping HRT for menopausal women

  • difference in breast cancer incidence per 1000 menopausal women over 7.5 years (95% confidence interval) (baseline population risk in the UK over 7.5 years: 22.48 per 1000)

Current HRT users

Treatment duration <5 years

Treatment duration 5-10 years

>5 years since stopping treatment

Women on oestrogen alone

RCT estimate

4 fewer (-11 to 8)

No available data

No available data

5 fewer (-11 to 2)

Women on oestrogen alone

Observational estimate

6 more (1 to 12

4 more (1 to 9)

5 more (-1 to 14)

5 fewer (-9 to -1)

Women on oestrogen + progestogen

RCT estimate

5 more (-4 to 36)

No available data

No available data

8 more (1 to 17)

Women on oestrogen + progestogen

Observational estimate

17 more (14 to 20)

12 more (6 to 19)

21 more (9 to 37)

9 fewer (-16 to 13

Reference:

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