Given the fact that October was breast cancer awareness month, I found the irony troubling of having to tell a patient that she has invasive breast cancer. It is never easy to tell a patient this news, but it always makes me take pause on the science behind these diagnoses.
This women had lived a very healthy life, never drank, never smoked, did not have a bad family history for breast cancer or any other major illnesses. She always was going through menopause and was looking for me to help her feel better and was considering hormone replacement. You see, her estrogen levels were very very low and she was starting to have the menopausal symptoms we have come to recognize easily.
Even though she had not yet started hormones, one of her first questions when I gave her the diagnosis was about hormones and can they cause breast cancer.
I answer this question on a daily basis with patients and it is the one that has the most amount of misinformation surrounding it.
Let me give you the unadulterated facts (without pharmaceutical bias or politics).
1) The studies have shown that estradiol alone does not cause breast cancer.
2) Our bodies have the highest levels of estrogen in them when our breast cancer risk is almost zero. It is not until we hit menopause (when our levels are at their lowest) that the risk goes up.
3) The study that showed a small increase in breast cancer was majorly flawed. Also, the the women in the arm of the study that showed this small increase in breast cancer were also on Medroxyprogesterone Acetate ( a very bad progesterone loaded with negative side effects for the body). It is this hormones which can cause breast cancer; not bio-identical progesterone or estrogens.
4) Testosterone ( a major hormone for health and well being) will LOWER breast cancer risk.
5) NOT ALL HORMONES ARE CREATED EQUAL! Our bodies were designed to be perfect. Estrogen was placed in our bodies for a major reason. It is when molecules which are not exactly the same as our original hormones are introduced issues may arise.
This patient had done everything right in her life and still developed breast cancer. Sometimes it is just sheer bad luck. The good news is that it was caught early. This will give her a great chance of a cure. It is through proper medical care and surveillance that allowed this to happen.
We can do everything right and sometimes things just go wrong. Mother nature has an evil twin.........and she is a real bitch.
- Dr. Angela DeRosa AKA "Dr. Hot Flash"
- Scottsdale, Arizona, United States
- Angela M. DeRosa DO, MBA, CPE graduated from the Chicago College of Osteopathic Medicine in 1995. She went on to do an Internal Medicine Residency with a fast track emphasis in Women’s Health at Lutheran General Hospital. After her residency, she became the Director of Women’s Health Services and Education at Lutheran General Hospital. After two years of practice she started a full time career as the West Coast Senior Medical Director with Procter and Gamble Pharmaceuticals. There she worked on women's health product development, research and marketing. Seven years after starting this position, Dr. DeRosa decided to pursue other clinical endeavors. Dr. DeRosa is a nationally recognized internist and women’s health expert. Her clinical focus is on revitalizing the physician-patient relationship; striving to provide the highest quality of care to her patients in a warm compassionate environment.