What to Know About Breast Cancer and Menopause

The link between breast cancer and menopause is complex. Research suggests that being in postmenopause may decrease the risk of breast cancer. However, other factors can increase risk, such as hormone therapy or age when starting menopause. Research indicates that risk of breast cancer links to estrogen and progesterone hormone levels. As a result, menopause and other factors that affect hormone levels may impact breast cancer risk.

Talk with a doctor if you have questions about breast cancer and menopause.

This article discusses the links between breast cancer and menopause, including risks, treatment, and breast cancer prevention.

The link between menopause and breast cancer risk is complex. Whether menopause increases breast cancer risk can vary.

A 2014 study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source notes that people in postmenopause have a lower risk of breast cancer compared with people of the same age and reproductive history in premenopause. Research also indicates that breast cancer tumors may be less aggressive Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source in people with a moderate weight who are in postmenopause.

However, more recent, larger studies are needed to confirm these links. Also, other factors related to menopause can affect breast cancer risk.

For example, the following factors may increase the risk of developing breast cancer:

• older age when entering menopause
• being overweight or obesity Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source after menopause
• hormone replacement therapy (HRT), a common treatment for menopause symptoms

A 2020 study Trusted Source BMJ Peer reviewed journal Go to source reports that:

• long-term HRT links to higher breast cancer risk
• combined estrogen and progesterone or more than one progesterone type HRT links to higher breast cancer risk
• risk declines after stopping HRT

Research also suggests that HRT following breast cancer could raise the risk Trusted Source American Cancer Society Highly respected international organization Go to source of it coming back.

Other factors that experts have linked to a higher risk of breast cancer include:

• older age
• genetic mutations of the genes BRCA1 and BRCA2
• dense breasts, breasts having more connective tissue than fatty tissue
• history of breast cancer and noncancerous breast conditions
• history of radiotherapy to the chest or breasts
• family history of breast or ovarian cancer
• exposure to the medication diethylstilbestrol (DES)
• lifestyle factors, such as:
  • drinking alcohol
  • lack of physical activity
  • having a first pregnancy at an older age, or never having a full-term pregnancy
  • not breastfeeding or chestfeeding

Read more about breast cancer causes, risk factors, and prevention.

Breast cancer more frequently occurs at an older age, so it may be more common around or after menopause.

One 2020 European study that took place over 13 years reports that the most common age range for breast cancer diagnosis was 51–70 years Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . The average age of menopause in the United States is 52 years Trusted Source Office on Women's Health Governmental authority Go to source .

A 2020 U.S. study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source finds that, in people assigned female at birth, 95.29% of breast cancer cases occurred after age 40.

However, more research is needed to confirm how common breast cancer is after menopause.

Your medical team will tailor a treatment plan to your personal factors, including medical history, breast cancer type, and condition.

Breast cancer tends to be less aggressive Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source in postmenopause. As a result, you may not need more aggressive treatments such as chemotherapy Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . Still, this depends on the type and stage of breast cancer you have. Currently, researchers believe that some people with HR-positive, HER2-negative breast cancer may not benefit from chemotherapy.

Standard treatments for breast cancer your medical team may recommend in postmenopause include:

• surgery to remove cancer cells or tumors
• chemotherapy
• radiotherapy
• targeted therapy, which targets the proteins that control cancer cell growth and spread

Estrogen and progesterone can encourage the growth of the breast cancer type hormone receptor-positive (HR-positive), or hormone-sensitive, breast cancer.

HR-positive breast cancer can respond well to hormone, or endocrine, therapy.

Aromatase inhibitors are a common breast cancer hormone therapy medication mainly used for people in postmenopause. These inhibitors work by blocking estrogen production and include:

• anastrozole (Arimidex)
• exemestane (Aromasin)
• letrozole (Femara)

Other breast cancer hormone therapies include:

• fulvestrant (Faslodex), which blocks estrogen’s action
• selective estrogen receptor modulators, which block estrogen receptors, and include:
  • toremifene (Fareston)
  • tamoxifen (Soltamox, Nolvadex)

Hormone therapy for breast cancer differs from HRT for menopause, as each therapy has different effects. Breast cancer hormone therapy blocks HR-positive cancer growth, while HRT for menopause can stimulate breast cancer growth.

If you have already had breast cancer and later want to treat menopause symptoms, doctors may not recommend HRT. HRT may increase Trusted Source American Cancer Society Highly respected international organization Go to source the chances of breast cancer coming back.

However, other treatments can help alleviate Trusted Source American Cancer Society Highly respected international organization Go to source menopause symptoms after breast cancer, such as Trusted Source Office on Women's Health Governmental authority Go to source :

• over-the-counter products for vaginal discomfort or dryness, such as lubricants or moisturizers
• low dose hormonal tablets, rings, or creams applied to the vagina
• prasterone (Intrarosa), to treat pain during sex
• medications for hot flashes and sweating, including:
  • gabapentin (Neurontin)
  • certain antidepressants, such as citalopram (Celexa), paroxetine (Brisdelle), or venlafaxine (Effexor, Vensir, Venlalix)
  • clonidine (Catapres, Kapvay, Nexiclon)
  • oxybutynin (Ditropan)
  • fezolinetant (Veozah)
• self-care, such as:
  • eating a diet high in phytoestrogens, found in soy, black cohosh, and red clover
  • maintaining a moderate weight
  • getting regular physical activity

Talk with your medical team before trying new medications or supplements, even if they are available OTC. Some products, such as certain antidepressants, can interact negatively with cancer maintenance treatments, such as tamoxifen (Nolvadex, Soltamox).

Read more about menopause symptoms, treatment, and management.

Sometimes, cancer treatments or withdrawal from cancer medications affect hormones in a way that:

• triggers Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source early menopause, which may be either permanent or temporary
• intensifies menopause symptoms or makes them more persistent
• causes menopause-like symptoms, even if you have already been through menopause

Cancer treatments that may affect menopause and its symptoms include:

• hormone therapy for cancer
• chemotherapy
• radiotherapy
• removal of the ovaries

There is no guaranteed way to prevent cancer. However, to reduce your risk Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source of breast cancer or improve your outcome if you do get it, try to:

• maintain a moderate weight
• drink little to no alcohol
• breastfeed or chestfeed your children
• talk with a doctor about HRT or hormonal contraceptives for any condition and ask if they are right for you
• find out if biological family members had breast cancer and talk with a doctor about your own risk
• ask a doctor about testing for BRCA1 and BRCA2 genetic mutations

Menopause can affect breast cancer risk. Postmenopause may reduce the risk of breast cancer. HRT, older age at menopause, and being overweight during postmenopause may increase risk.

Breast cancer treatment may vary slightly depending on whether you have gone through menopause. Similarly, if you have had breast cancer, doctors may tailor menopause treatment to your medical history.

Talk with a doctor if you have questions about breast cancer, menopause, or your health.