• If a very close relative, such as your mother or sister, developed breast cancer, although recent evidence suggests this may be less of a risk than was once thought.

• If you have ‘benign’ breast disease (your doctor would tell you if you have); this is not always a higher risk factor in itself, but as lumpy breasts make the detection of cancer more difficult, some doctors prefer their patients not to take HRT.

• If you finished your periods later than average, that is you had a late menopause (after about the age of 55).

• If you are very overweight.

None of these means that you will get breast cancer, just that your chances of getting it are higher than for women who don’t fit into any of these categories.

From the last two in the list, you will see that there appears to be a link between oestrogen and breast cancer. In other words, women who have been producing oestrogen for longer than average have a higher than average risk of developing breast cancer. So, if these women take HRT for many years more, this risk will increase further, and this is something they should be aware of, so that they can make an informed decision. Even so, it is only a risk, not a certainty.

Conversely, you are at a lower than average risk of developing breast cancer if you had an early menopause (whether surgical or natural); the ‘downside’ for this group of women is that, because they produced oestrogen for a shorter than average time, they are at an increased risk of developing osteoporosis. It seems we really can’t win!

Some breast cancer tumours depend on oestrogen to grow, and some don’t. If your breast cancer developed before the menopause (that is, while you were still producing oestrogen), then HRT is a definite NO for you; but if it developed long afterwards, then in some cases HRT may be acceptable. This is a situation where you and your doctor will have to balance the risks against the benefits. It is obviously difficult to work out these risks and benefits. Most research identifies the risks to the population at large, whereas you want to know how it might affect you as an individual, regardless of how it might affect anybody else. Your doctor or specialist should be able to help you.

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