Ending the Prohibition: Modern Hormone Therapy for Breast Cancer Survivors

The utilization of hormone therapy (HT) in women with a history of breast cancer has been restricted for decades. These restrictions originate primarily from early trial data, notably the HABITS trial, which raised concerns about recurrence risk. However, subsequent trials and observational studies, along with advancements in our understanding of hormone pharmacodynamics, call for a reassessment. Not all hormone therapy is the same; distinctions in formulation, route, dose, and timing may significantly alter risk profiles. This article explores these nuances and proposes a more balanced and up-to-date clinical framework. Given that no contemporary observational evidence demonstrates increased breast cancer recurrence or mortality risk from transdermal estradiol and oral micronized progesterone, continuing to impose an absolute contraindication lacks scientific justification and shifts the burden of proof unfairly onto a therapy with well-documented systemic benefits.