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. 2024 Jan;56(1):143-148.
doi: 10.4143/crt.2023.653. Epub 2023 Aug 16.

Short-term Impact of Hormone Replacement Therapy on Risk of Breast Cancer in BRCA Mutation Carriers: A Nationwide Study in South Korea

Hye Yeon Kim  1 , Jisoo Park  1 , Seok Joo Moon  2 , Sohyeon Jeong  1 , Jin Hwa Hong  1 , Jae Kwan Lee  1 , Geum Joon Cho  1   2 , Hyun-Woong Cho  1
Affiliations

Short-term Impact of Hormone Replacement Therapy on Risk of Breast Cancer in BRCA Mutation Carriers: A Nationwide Study in South Korea

Hye Yeon Kim et al. Cancer Res Treat. 2024 Jan.

Abstract

Purpose: BRCA1/2 mutations are well-known risk factors for breast and ovarian cancers in women. Risk-reducing salpingo-oophorectomy (RRSO) is the standard treatment for preventing ovarian cancer with BRCA mutations. Postmenopausal syndrome (symptoms after RRSO can be alleviated by hormone replacement therapy (HRT); however, the use of HRT in carriers of BRCA mutations has been controversial because of the concern that HRT increases the risk of breast cancer. This study aimed to evaluate the effects of HRT in BRCA mutation carriers who underwent RRSO.

Materials and methods: A total of 151 carriers, who underwent RRSO between 2013 and 2020 after the diagnosis of BRCA1 or BRCA2 mutations were selected and followed up for a median of 3.03 years. Patients were divided into two groups: those who received HRT after RRSO (n=33) and those who did not (n=118). We compared the incidence of breast cancer over time between these two groups.

Results: There was no significant difference in the incidence of breast cancer between women who received HRT and those who did not (p=0.229). Multivariate logistic regression analysis, adjusted for age and parity revealed no significant difference in the risk of breast cancer between these two groups (hazard ratio, 0.312; 95% confidence interval, 0.039 to 2.480; p=0.278).

Conclusion: In this study, we found no relationship between post-RRSO HRT and breast cancer in the population with BRCA mutations. Therefore, healthcare providers may consider the alleviation of symptoms of postmenopausal syndrome through HRT in patients who underwent RRSO.

Keywords: BRCA1; BRCA2; Breast neoplasms; Female; Genes; Germ-line mutation; Hormone replacement therapy.

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Conflict of interest statement

Conflicts of Interest

Conflict of interest relevant to this article was not reported.

Figures

Fig. 1.
Fig. 1.
Flow chart of the study. HIRA, Health Insurance Review & Assessment Service; RRSO, risk-reducing salpingo-oophorectomy.
Fig. 2.
Fig. 2.
Breast cancer incidence among BRCA mutation carriers by hormone replacement therapy (HRT) use. (A) Breast cancer incidence among BRCA mutation carriers who used any HRT compared with women who did not use HRT. (B) Breast cancer incidence among BRCA mutation carriers under the age of 45, who used any HRT compared with women who did not use HRT. (C) Breast cancer incidence among BRCA mutation carriers over the age of 45 who used any HRT compared with women who did not use HRT.
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