Breast cancer and replacement therapy: which women are at risk?

The fear of breast cancer is the most important concern for women who have to decide whether to take hormone replacement therapy (HRT) for the treatment and prevention of postmenopausal disturbances. A calculation of the risk for breast cancer with respect to HRT is useful to reassure women about this risk and to help them to decide. In the present report, all breast cancer risk factors have been examined and those likely worsened by increased levels of estrogens with HRT have been considered. On the basis of pathogenic, clinical and epidemiological evidence seven breast risk factors (testosterone levels, body mass index, waist-to-hip ratio, alcohol consumption, density to mammography, previous benign breast disease, familiarity) have been selected and a score has been awarded to them; then a model for the calculation of the SRR (Summary Relative Risk) has been elaborated. A simple, feasible, easy to achieve decision model for the calculation of breast cancer risk is proposed in relation to the use of HRT.