Osteoporosis after broken ankle

You're likely referring to this article from The Lancet:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31709-X/fulltext
As you pointed out, the conclusion from this meta-analysis showed a higher estimated risk of breast cancer compared to some other publications. However, the analysis was based on pooled data across all types of menopausal hormone therapy (MHT), with synthetic progestin -specifically medroxyprogesterone acetate (MPA) - making up thr majority of the data set, likely skewing thr risk estimate upwards.

The current preferred HRT/MHT regimen among obgyn is transdermal estradiol, combined with oral or vaginal micronized progesterone for those with a uterus. However, studies or meta-analysis focused on this regimen are very limited.

According to this review paper https://pubmed.ncbi.nlm.nih.gov/29384406/ , " estrogens combined with oral (approved) or vaginal (off-label use) micronized progesterone do not increase breast cancer risk for up to 5 years of treatment duration". When used for more than 5yrs, etimates of the absolute risk (for transdermal E2) might rise by 0.5-1% over 10 years compared to non-users, but is not statistically significant in most studies.

https://journals.lww.com/menopausejournal/fulltext/2024/05000/use_of_menopausal_hormone_therapy_beyond_age_65.3.aspx : this paper, based on very large prescription database, includes an interesting breakdown of health outcomes - such as breast cancer - by hrt type, route and dosage. While you are not in the same age cohort, I thought it's worthwhile to take a look.

Hi Nikita,
I broke my ankle in August 2023 and broke my shoulder in February of 2022.
I had also been having issues with Menopause when my gynocologist asked me why I didn't go on HRT. She said the chance of breast cancer was overblown and there was additional evidence suggesting it actually had many advantages especially if I had Osteoporosis. I went on it In January 2023 when I was 56 and after lowering the dosage a bit -it has been amazing. There is a lot of misinformation regarding HRT and breast cancer. It IS definitely worth the risk. Read up on the newest information first though.

Thanks Sibley. I am trying to become educated. It is so reassuring to hear from others my age using this successfully. I think this is what I should do. I filled the prescription. I plan to start tomorrow.

Thank you for explaining this to me. It really helps to hear from someone like you who has a grasp of all this. I am definitely still on the learning curve. My PCP wanted me to take Fosamax. She agreed to give me HRT, but she knew nothing about it, so I had to tell her what I wanted. I have an appointment to visit my gynecologist, but I cannot get in for 2 months. So now I have the prescription: 0.025 mg/day Estradiol twice weekly patch. The Lancet study you posted is the one I read. That study indicated that sequential dosing resulted in less breast cancer, so I have 200 mg of progesterone to take for 12 days. No one has indicated how to take it, but I think I am to take it on the 17th day at the end of the cycle. Do you think the sequential dosing is a mistake for someone just starting this? I was basically prescribing for myself since my PCP was opposed to HRT in favor of Fosamax.