Hormone Replacement Therapy and Breast Diseases: A Matter of Concern for the Gynecologist

Background: The carcinogenic effect of exogenous steroid hormones on thebreasts is a matter of debate, causing confusion for physicians at the time of makingprescriptions. This article, as part of a quadruple series about exogenous sexhormones and breast disorders, reviews the association of breast cancer andhormone replacement therapy (HRT) in the general population, women withbenign breast disorders, women with personal or family history of breast cancer,and BRCA carriers. Methods: We accomplished an extensive search of the literature by usingrelevant keywords to identify pertinent cohort studies, clinical trials, and reviews.Then, we extracted all points regarding the question. Results: An extensive literature exists on the risk of breast cancer followingHRT in the general population, and HRT has been mentioned as a risk factor forbreast cancer, especially in recent, long-term users of combined formulations.However, there is still no consensus about it. Conversely, few studies haveconsidered challenging issues like the use of HRT in breast cancer survivors andhigh-risk women. Conclusion: HRT up to ۵ years can safely be used for management ofmenopausal symptoms in healthy women, and those with low-risk benign breastdisorders. On the contrary, its use in high-risk women should be limited torefractory menopausal symptoms after describing potential harms to the patient.