Is it recommended for carriers to take hormone replacement therapy?
Many women who carry a mutation in BRCA undergo ovarian and fallopian tube resection before premature menopause. Afterwards, there is an ongoing debate about whether to take or avoid hormone replacement therapy.
Ovarian, fallopian tube and peritoneal tumors are not hormone dependent. To the best of our knowledge, the risk for these cancers does not increase due to taking hormone replacement therapy.
Regarding breast tumors, some are hormone-dependent and carry receptors for estrogen and progesterone. Following the publication of the WHI (Women’s Health Initiative) findings, the long-standing controversy in medical literature regarding the effect of hormone therapy on breast cancer risk has ended. A large study involving more than 160,000 menopausal women found that taking combined hormonal preparations (estrogen + progestogen) increases the risk of developing breast malignancies by about 25%, as well as increases the risk of dying from breast tumors. These increased risks decrease quickly after the hormone therapy is discontinued.
However, data available in medical literature differs regarding the carrier population. A leading group of researchers reported that in carriers who underwent ovarian and fallopian tube resection, taking combined hormonal therapy did not impair the beneficial effect of ovarian resection itself, and the risk of breast tumors did not increase. Another article on this topic demonstrated a reduced risk of breast cancer, with a higher significance for women who took estrogen therapy compared to combined hormonal therapy.