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Is Hormone Replacement Therapy Safe in Women With a BRCA Mutation?: A Systematic Review of the Contemporary Literature

Birrer, Nicole, BA; Chinchilla, Carolina, BS; Del Carmen, Marcela, MD, FACOG; Dizon, Don, S., MD, FACP

American Journal of Clinical Oncology: March 2018 - Volume 41 - Issue 3 - p 313–315
doi: 10.1097/COC.0000000000000269
Original Articles: Breast
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Objectives: Women with a BRCA1 or BRCA2 mutation are recommended to undergo prophylactic (or risk reducing) bilateral salpingo-oophorectomy (BSO) before age 40, resulting in surgical menopause. Given the concerns of estrogen deprivation on overall health, hormone therapy (HT) is often discussed, yet safety concerns persist.

Materials and Methods: We performed a systematic literature review of the safety of HT in women with a BRCA mutation undergoing prophylactic BSO.

Results: Although there remains a paucity of data on this topic, as evidenced by this systematic review of the contemporary literature, these patients do benefit from treatment, especially as it relates to menopausal symptoms without an apparently increased risk of breast cancer.

Conclusions: Decisions regarding the use of HT in women who undergo BSO after detection of a BRCA mutation must be individualized based on careful consideration of the risks and benefits. However, the risks of a subsequent cancer diagnosis appear small, particularly in regards to the benefits of treatment afforded by HT.

Division of Gynecologic Oncology, Massachusetts General Hospital Cancer Center, Boston, MA

The authors declare no conflicts of interest.

Reprints: Don S. Dizon, MD, FACP, Massachusetts General Hospital Cancer Center, 55 Fruit Street, Yawkey 9E, Boston, MA 02114. E-mail: ddizon@partners.org.

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