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Committee Opinion No. 659 Summary

The Use of Vaginal Estrogen in Women With a History of Estrogen-Dependent Breast Cancer

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doi: 10.1097/AOG.0000000000001349
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Abstract

Recommendations and Conclusions

The American College of Obstetricians and Gynecologists makes the following recommendations and conclusions:

  • Nonhormonal approaches are the first-line choices for managing urogenital symptoms or atrophyrelated urinary symptoms experienced by women during or after treatment for breast cancer.
  • Among women with a history of estrogen-dependent breast cancer who are experiencing urogenital symptoms, vaginal estrogen should be reserved for those patients who are unresponsive to nonhormonal remedies.
  • The decision to use vaginal estrogen may be made in coordination with a woman’s oncologist. Additionally, it should be preceded by an informed decision-making and consent process in which the woman has the information and resources to consider the benefits and potential risks of low-dose vaginal estrogen.
  • Data do not show an increased risk of cancer recurrence among women currently undergoing treatment for breast cancer or those with a personal history of breast cancer who use vaginal estrogen to relieve urogenital symptoms.
© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.