Estrogen and Breast Cancer: What You Should Know

[@pbj91]

My experience is they don’t want to hear it. (When we complain about side effects of aromatase inhibitors). I showed my doctor a study that showed taking Exemestane 3 times a week produced EQUAL results to a group taking it daily in terms of estrogen levels. My doctor said that it was a short term study and we don’t have long term studies on taking AI’s less than daily. So why don’t we? I’m on Anastrozole and it’s been around for nearly 30 years. I personally think it’s because of the drug companies. No one wants to fund a study showing the results of taking LESS medication. So we take these drugs every day as victims of breast cancer, deal with the side effects of no estrogen, and hope and pray we don’t get heart disease or dementia or osteoporosis, etc. I understand that estrogen fuels breast cancer, but just wish we knew if taking estrogen lowering drugs less than daily would keep breast cancer away just as well.

[@Elenitsa21]

You are so right. It’s so frustrating to know we’re taking an AI daily to prevent a recurrence yet this same AI is causing harm to our brain, bones, heart…Estrogen is beneficial to our health and we’re completely being zapped of it. I’m so worried.

[@laurarenfro5136]

What if estrodial fuels the anti-inflammatory and protects while estrodone promotes it.

[@yerbba]

It’s incredibly frustrating to feel unheard, especially when dealing with the side effects of aromatase inhibitors. The research you're referring to was done in people with Stage I HER2-negative breast cancer. It has shown that taking exemestane three times per week may be as effective as daily dosing in postmenopausal women with estrogen receptor-positive breast cancer and you're right, had relatively short followup. Clinical trials demonstrated similar reductions in estradiol levels and biomarkers between the two dosing schedules, though longer studies are needed to confirm long-term effects. Because only people with with Stage I estrogen receptor-positive, HER2-negative breast cancer, it's difficult to know if people at higher risk would have the same outcomes. For anyone else on AI therapy, don’t hesitate to push for solutions to improve your quality of life-it’s your body, and your voice matters. Oh, and we agree that industry is not interested in giving less of their drug.

[@pbj91]

@@yerbba thanks for the reply. Just curious ..the trial I brought up with my oncologist from 2023 was titled, “The Efficacy of Alternative Dosing Regimes of Exemestane in Post-Menopausal Women With Stage 0-II Estrogen Receptor Positive Breast Cancer” so doesn’t that mean women up to Stage II were included? Also, I found it funny that although my doctor was unreceptive to me taking my AI less than daily, my mom’s oncologist (she also had breast cancer) told her she could go ahead and take her Exemestane 3 times per week. Maybe because she’s older her doctor was ok with it

[@trillianmcmillian2660]

@@pbj91maybe because she is post menopausal

[@deschelbutler4859]

The frustrating thing is that the medical community still has no clue where cancer starts and how to treat it besides things that harm your body. Chemotherapy was a lot and I still don't feel like myself a year later. Anatrozole is kicking my behind. Can't sleep, muscle aches, and anxiety.

[@yerbba]

Absolutely right. We have a lot more to learn.

[@ShoppingEmail-dr1fs]

so true. there is no idea how to truly prevent or treat.

[@conniejohnsoncj8724]

Why is it a one pill fits all aromatase inhibitors? Our bodies talk to us through symptoms so people who are experiencing severe side effects, should maybe have less aromatase? Have doctors prescribed half a pill or an every other day pill, or 2 days on one day off to see if side effects lessen and become tolerable! If not, why? It seems the medical field finds something that works but doesn’t work on the fall out of side effects and how that varies from person to person.

[@ruthwolf1958]

This! I know from genetic metabolism testing that I'm an intermediate metabolizer of letrozole, so it stays in my body longer than is typical. I have concerns that means I could have more of it building up and potentially causing side effects if I take it 2.5 mg daily. But there doesn't seem to be much data or interest in acquiring it for lower dosing vs. effectiveness. But then, maybe they don't want to play with this because they've found something that generally works well and produces the desired result and trying to find out could risk recurrence for people? But if people can't stay on it due to side effects, and trying the one month off/try it again or switching AIs doesn't help, it does make you wonder if adjusting the dosing otherwise is better than nothing or could still be OK?

[@janeellis4926]

I've read that every other day dosing is generally just as effective. Even if you don't feel bad you are damaging your bones.

[@conniejohnsoncj8724]

@ my oncologist said there hasn’t been any confirmed studies on dosing other than the dosage of the pills every day!

[@janeellis4926]

@ l have seen studies so they do exist. My doctor acknowledged that she has patients taking every other day but it makes nervous. I am matastatic. I have a friend who goes to the same clinic (different oncologist). He said every other day is fine.

[@ruthwolf1958]

@@janeellis4926 this too. If the lower dose is effective, could it also help mitigate bone density issues or is the bone density effect simply from blocking estrogen at all.

[@inekeblom33]

Dear Dr Griggs. I'm Dutch and I live already over 20 years in France. I'm diagnose with breast cancer in October during a "depistage de cancer'. Just a small tumor and no susceptive things on botscan and TAP (thorax abdomen palvis) scan. So Think I'm lucky. Next wednesday I'll have surgery: remove the tumor and they wille take some lymph nodes .I want to thank you for your videos. Yours and those of dr Liz O'Riordan helped me a lot to understand everything. And they prepared me to ask the wright questions .

[@yerbba]

Thank you for sharing your story. It sounds like you’ve taken such an active role in preparing for your surgery and treatment. Asking the right questions is such a crucial part of this process, and it’s wonderful that the videos have helped you feel more confident. Wishing you a smooth surgery and recovery-sending strength your way from all of us here. Merci beaucoup.

[@abasu8279]

Does that necessarily mean estrogen blocker in er positive breast cancer is bad for heart ? (I mean aromatase inhibitors)

[@yerbba]

There is some evidence that the aromatase inhibitors increase the risk of cardiac events since there is an elevation of so called "bad cholesterol" and less protection from the body's own estrogen.

[@Yasmin-h6z]

Hi Dr dose flaxseed lowers estrogen leavel

[@yerbba]

Flaxseed contains lignans, which are plant compounds that can mimic or modulate estrogen. While they have been studied for their potential to balance hormones, their overall effect is not fully understood. We’ve covered flaxseeds in this video: [kzbin.info/www/bejne/pnPHf3iahJWtqaM ] and the safety of estrogen in foods here: [kzbin.info/www/bejne/boHTZ4Z6oNGfp80]

[@meritabuff741]

I’m 80 years old had breast cancer 20/23 stage 1 had 16 radation treatments no chemo my dr. Took out 1 limp node to see if cancer was n it no cancer was found n limp node my oncologist Dr. put me on anastrozole taken every day 1 milg I’m takeing it fine been on it for 1 yr I went for a Mamagram Friday Dec 20/24 on both breast it was good and i had a lumpn not a complete removal of my breast but m doing really good Praying for all women who has had their breast remove from cancer m Blessed Thank u Jesus 🙏♥️

[@denisemodica9792]

This is such important information ⭐️⭐️⭐️

[@yerbba]

We truly appreciate your feedback and are so glad this topic was relevant!

[@marlongreeb831]

Dear Doctor, please help us to understand about brain metastatic through breast cancer and how to Corp with it.

[@yerbba]

Coping with brain metastases from breast cancer is incredibly challenging, and we wish you weren't going through this. It’s important to work closely with your care team to understand your treatment options, which may include targeted therapy, immunotherapy, radiation (like stereotactic radiosurgery), or surgery. Managing symptoms like headaches or memory issues with medications such as steroids or anti-seizure treatments can help improve daily life. Emotional support is vital-connecting with a counselor or support group can make a big difference. Lean on loved ones for help, and prioritize quality of life by taking breaks, focusing on comfort, and enjoying small, meaningful moments.

[@cm1906]

How do you explain the 23% decrease in breast cancer in the WHI estrogen-only arm?

[@yerbba]

Estrogen only is not associated with an increase in the risk of breast cancer. In fact, as you point out, research suggests that estrogen-only therapy may protect against breast cancer. The mechanism is though to be through changing how the body breaks down estrogen. Women using estrogen alone showed higher levels of protective estrogen breakdown products (called 2-pathway metabolites) compared to harmful ones (16-pathway metabolites). This metabolic pattern has been linked to lower breast cancer risk in postmenopausal women. It's important to note that so-called "unopposed estrogen" (estrogen without progesterone) is not safe in people who have a uterus.

[@marlarangeloff5163]

It is using synthetic progesterone that puts you at risk. If you take estradiol with natural progesterone it protects you from breast cancer

[@mcanultymichelle]

So would you not recommend HRT therapy????

[@Elenitsa21]

Great video once again! Seeing how the avg menopausal age is around 50 and we have another 20-30 years lifespan, how does a 51 year old woman on letrozole for recurrence prevention protect her brain, heart, bones and so on, since our estrogen levels are completely depleted. Yet estrogen is so important to so many of our organs.

[@yerbba]

These are real concerns, we agree. One thing that may be helpful to know is that the effects on bone, etc. are reversible.

[@rnla7034]

They don't care. Honestly, completely oncofocused on the cancer and they don't see that we are whole persons. The effects of stripping women of our estrogen are disastrous...and they're not searching for an answer. We're even denied vaginal estrogen, which is a local treatment to simply relieve the tissue destruction in that area- but if you have a history of BC- no prescription. Just suffer, let your body self-destruct, they don't care.

[@HL-qv3yd]

Dear dr Griggs, I also like to ask removing ovary is better than zoledex? Or removing ovaries how effective estrogen for BC diagnosis womans ❤

[@ginawhittaker2585]

I’m a fifty year old woman and my periods are irregular, I’ve been having hair thinning for years and for a while now if I run or cough really hard I leak urine. So when I go for my yearly check up this month I was thinking about seeing if she can put me on estrogen. I don’t want to be on it long, what’s the shortest amount of time you would recommend. Also I got my period fairly young and I’m not sure when I’ll go through menopause, I’m assuming I might be in the early stages of perimenopause but I’m not sure I feel fine except for what I already mentioned.

[@laurarenfro5136]

GSM symptoms are starting - Followed by HSDD- VSM and the cherry on top--insomnia

[@MaryBethMcCoy]

You should have your hormone levels checked as part of your evaluation. Only after you have those results can an accurate plan going forward be determined to help your symptoms.

[@CarrieNoble-j4q]

Having problems with leaking in pants can be a result of having several births , not much to do with estrogen. A good surgeon can take care of your problem instead of depending on estrogen for most of your life.

[@mineandmitch]

Can you explain why in ER+ BC is treated with inhibitors and what that does? And maybe also explain how the BC uses ER to grow?

[@deejohnson4793]

Does eating red meat after the estrogen positive diagnosis contribute to tumor growth? Am taking anastrozole. Thanks for informative videos.

[@yerbba]

Red meat does not appear to increase the risk of recurrence, no. You may find our video on red meat to be helpful: kzbin.info/www/bejne/bHOUlnd5bcunr8k

[@lorettacsandoval7795]

I had stage 2 grade 2 TNBC diagnosis and am almost one year post treatment. I had a compete hysterectomy and was on HRT creams and Rx progesterone for 13 years years which I discontinued at diagnosis in Feb. 2023 and would like to go back on HRT parches or cream as I feel and sleep better when on HRT. What is known about the increased risk of either TNBC returning or Hormone receptor cancer initiating after a 1.5 yr gap taking HRT and resumimg it?

[@yerbba]

It’s understandable to want to resume HRT for better sleep and overall well-being, but it's a complex situation. Hormone replacement therapy can potentially increase risks, especially after TNBC or any breast cancer. Speak with a specialist about safer options, like non-hormonal therapies, to improve sleep and quality of life. There may also be natural approaches or lifestyle changes to explore. You may find our video on the safety of HRT to be helpful here [kzbin.info/www/bejne/r2nMqZeqqdOohaM]. There are people who challenge this dogma, but the risk of recurrence may outweigh the benefits in many people.

[@jonathan_1465]

One minor correction: estrogen is a direct cause of breast cancer but only 1/3rd of them, according to Harvard research published in the 5/17/23 issue of NATURE. The team showed that the hormone led to errant genomic reshuffling following DNA breaks. This was a brand new mechanism they uncovered contrary to the classical "promoter" model. For estrogen to merely fuel breast cancer doesn't make sense because hormone modulating chemoprevention or oophorectomy would only delay breast cancer development as opposed to true prevention.

[@yerbba]

Thanks for your thoughts. You're referring to the article published in Nature on May 17, 2023, titled "ERα-associated translocations underlie oncogene amplification in breast cancer." The interpretation you provide, however, is not quite accurate. The study actually shows that estrogen receptor binding can lead to DNA breaks and translocations that may contribute to oncogene amplification in breast cancer, affecting about 31% of breast cancer cases. This is quite different from claour comment, "estrogen is a direct cause of breast cancer but only 1/3rd of them." The research describes a specific mechanism involving DNA repair and genomic rearrangements rather than establishing direct causation.

[@jonathan_1465]

@@yerbba Thanks for the feedback. Yes, I should definitely rephrase the "direct cause" statement. ;) But it is very telling that estrogen's role is still being elucidated even though treatment and prevention seem pretty clear cut. I would agree that the mere presence of estrogen doesn't cause breast cancer just as a carbohydrate molecule doesn't cause diabetes, since nothing happens in a vacuum. Rather, like with unopposed estrogen-uterine cancer, it's a case of excess.

[@CarrieNoble-j4q]

None of this has been proven so why take a risk ? I want to do everything in my power to be here for my grandchildren . If I do get breast cancer at least I will not regret having taken supplements

[@CarrieNoble-j4q]

I never knew my grandmother who died of breast cancer when I was two years old . She was on estrogen supplements , maybe there was a direct link or maybe not , but for me it changed my life for the worse because of her death .

[@jonathan_1465]

@@CarrieNoble-j4q My mother also took Premarin and Provera for 5 years before she was diagnosed with a high grade ER+ cancer at age 50. Her doctor had started her on it at 45 even though she wasn't even perimenopausal - his thinking was, well you're 45 - it's never too early to start. So needless to say, her diagnosis meant no more hormone "replacement." Thankfully, she's healthy now at 78.

[@cm1906]

To just talk about “estrogen” here is very simplistic. Why not mention estrone, which is the primary estrogen produced in post menopause and is pro inflammatory, as opposed to estradiol, which is our most potent (and anti-inflammatory!) premenopausal estrogen needed for all the important organ functions you mention here (bone, brain, heart, etc). Additionally, what evidence is there that estradiol “given from the outside” causes breast cancer? Why would it matter that a molecularly identical hormone traveling through the blood stream is coming from the ovaries or absorbed through the skin? I would like to understand. Making claims without providing evidence is not helping women make informed decisions about their health.

[@yerbba]

These are terrific questions, and we'll do our best to answer them. Please note that what follows is from animal models and cell lines and not in human beings. Many times, the discoveries made in animal models (which are artificial and manipulate hormonal levels) and cell lines are not borne out in people. The relationship between estrone (E1) and estradiol (E2) appears to play a role in cancer risk and inflammation, with distinct effects before and after menopause. Before menopause, estradiol predominates and exhibits protective properties, including anti-inflammatory effects and suppression of cancer-promoting genes. After menopause, estrone becomes the dominant form, primarily produced in fat tissue, and tends to promote inflammation and increase cancer stem cells. At the molecular level, estrone stimulates processes that can lead to cancer progression, including epithelial-to-mesenchymal transition, cancer cell invasion, and metastasis, while activating inflammatory pathways through NF-κB. In contrast, estradiol suppresses these cancer-promoting processes and opposes inflammatory pathways. This difference nay explain in part the relationship between obesity, which increases estrone production in fat tissue, and cancer risk in postmenopausal women.

[@CarrieNoble-j4q]

Until we know with absolute certainty accuracy why take a chance with estrogen supplements ? Breast cancer is so dangerous that is it worth the risk to take estrogen ? I do not believe that women who do not take any supplements have a higher risk than women who who do take supplements , as previously mentioned. Other than taking supplements or not taking them they were no difference in lifestyles with the members of my family either taking estrogen or not . This certainly is not in any way scientifically proven , but I would never take a supplement just to prove everything will work out fine. Too much of a risk for even one woman who could develop breast cancer in my humble opinion.

[@CarrieNoble-j4q]

There is an entirely different definition of estrogen taken pill form compared to natural estrogen

[@jt8142]

Your info is wrong on the incident of breast cancer in women on HRT. You’ve quoted debunked info on relative risk (not absolute risk). 👎 👎 👎

[@yerbba]

Here's some hot off the press, up to date information: Hormone replacement therapy (HRT) carries varying breast cancer risks depending on the type and duration of treatment. Estrogen-only HRT shows minimal risk increase, while combined HRT (estrogen with progestogen) presents higher risks, especially with longer use. In the UK, among women aged 50-69, about 63 per 1000 non-HRT users develop breast cancer. With 5 years of HRT use, there are approximately 5 extra cases per 1000 women for estrogen-only HRT, 14 extra cases for sequential combined HRT, and 20 extra cases for continuous combined HRT. These risks roughly double with 10 years of use. We hope this is helpful. A 2020 study of nearly 100,000 women with breast cancer and over 450,000 controls found combined HRT slightly increased breast cancer risk, varying by age, duration, and recency. Current and long-term users faced higher risks, with progestogen types playing a role. Among 10,000 women in their 50s using short-term combined HRT, only 9 extra cases occurred annually. No increased risk was seen with short-term HRT, past estrogen-only therapy, or combined HRT stopped over 5 years ago.

[@MaryBethMcCoy]

I agree. Also, the research indicates that as women in the WHI study have continued to be followed over the years, those on HRT actually had less incidence of breast cancer than those not taking it, not to mention the fact that the WHI study was very flawed in the first place.

[@JanetMarsh-ji6rj]

Dear Dr Griggs, Thank you for your informative video. After considering whether or not to continue with Letrozole (am currently on an oncology approved 6 week break) your statements 'oestrogen does not cause breast cancer' and 'your own oestrogen is not bad for you' I have decided to stop taking it.

[@agapeeros9743]

lol

[@yerbba]

We hope you read this. Despite the fact that estrogen in our own bodies does not cause breast cancer, reducing estrogen levels with aromatase inhibitors or blocking estrogen from getting to the receptors increases the likelihood of cure. The aromatase inhibitors are a major advance in breast cancer care.

[@rnla7034]

Absolute vs relative risk. The numbers are not what we're led to believe. Aadjuvant therapy is a shot in the dark. No one really knows...and if you press your oncologist long enough, they admit this. I don't trust pharma. I had no choice but to do neo-a chemo, but we simply are NOT smarter than God in understanding the fine balance of hormones for optimal health. Women are SUFFERING. The pills aren't making us live longer, just die slower. No thanks.

[@mollypaintscows]

It’s the outside fake estrogens that you have to watch out for. I.E. scented candles; dryer sheets; ingredients in cosmetics and soaps, estrogens in food, the plastic non wood cutting boards etc. Xenoestogens (spelling ?) are all over the place. It’s difficult to escape them.

[@laurarenfro5136]

Has anyone heard of MTOR? Longevity and for diabetes however cancer hates it.

[@feminineheart]

Estrogen doesn’t cause breast cancer. Common sense. Our estrogen is highest in teen and young adult years when breast cancer rates are lowest.

[@CarrieNoble-j4q]

Yes it does . My grandmother died of breast cancer cancer , my mother had breast cancer and so did my sister . Natural estrogen is fine , we produce it when we are young . However , if we add estrogen by pill form , that is an entirely different problem . I am almost 80 years old and I have been fine.,I might be wrong but the women who have taken estrogen by pill form , almost 80 percent did have breast cancer when no family history was shown . Why take a chance , breast cancer is so devastating .

[@feminineheart]

@ noooo. 80% of women taking oral estrogen got breast cancer? Are you kidding me? This kind of misinformation is the reason why women can’t access help. My grandmother, and mother had breast cancer. I’ve been on estrogen almost 26 years! Please stop spreading misinformation.

[@mollypaintscows]

@@CarrieNoble-j4q. are you referring to birth control pills when you mention women who have taken estrogen by pill form?