@debbie1956 I wish there was more definitive research on HRT and breast cancer. I am still confused and taking the precautionary approach. I wish I could use HRT for my general health and even for bone maintenance- after medications- but my history of cancer, for me, makes HRT a big no and I worry that this matter has not been adequately settled as yet for others.

Dr. Gersh's video is great but she does not seem to understand the risk of recurrence for hormonal breast cancer continues to go up even after 5 years. In fact risk rises forever for hormonal cancers, She implied that HRT would not be approved for more recent breast cancer but might be appropriate after 5 years and that is just wrong, based on risk increase over that time.

Apparently the idea in her video and the study posted above is that estrogen (estradiol) does not cause hormonal cancer but can make existing cancers grow (or recur, spread). But there are still problems.....

Dr. Gersh also does not seem to understand that clear margins and lymph nodes does not mean that no cancer cells are circulating in the body. I read once that doctors should never say "we got it all." That is just not how it works.

I also wonder about women (and men) who have breast cancer that has started but is not yet detectable. What will hormones do in that case? The statistic of one in 8 women getting breast cancer is real and the majority are over 60.

In the study posted by @gently, the statistics for risk reduction for breast cancer with HRT- (except for combos with progestin/progesterone or progestin alone, which raise risk) were really reassuring to read. Much more convincing than Dr. Gersh. However I did note that HRT was mostly prescribed to women without an "intact uterus." What does that mean for the study? It is unclear. Here is the conclusion:

"Our study suggests the possibility of important health benefits with use of menopausal HT beyond age 65 years. The use of ET, mostly prescribed to women without intact uterus, can protect against risks of all-cause mortality, developing cancers (breast, lung, and colorectal), CHF, VTE, AF, AMI, and dementia. The implications of EPT for women who still have their uterus are less clear. The use of EPT does not increase risks for almost all conditions but does increase the risk of breast cancer. However, low dose of transdermal and vaginal EPT (especially E+ progestin) can mitigate the risk of breast cancer. In general, risk reductions appear to be greater with low rather than medium or high doses, vaginal or transdermal rather than oral preparations, and with E2 rather than CEE as emphasized by others.35

Our follow-up began when women entered Medicare at about age 65 years, but it is likely that many of them started taking HT closer to the time of their menopausal symptoms and continued it into their Medicare years. If so, our positive results align with the timing hypotheses36 that asserts that HT use early in menopauses is better than later, but extend it by reporting positive effects with usage continued into Medicare years. Our findings offer important insights into the variations among different menopausal hormone therapies, which could assist in tailoring postmenopausal HT on an individual basis."