Menopause and Breast Cancer: What Is the Relationship?

No data exist that show menopause directly causes breast cancer. However, late-onset menopause may increase the risk of breast cancer due to prolonged hormone exposure throughout life.

Certain types of breast cancer treatment called hormone therapy can induce (bring about) menopause, as well.

This article discusses the connection, risks, treatment, and prevention of breast cancer at the time of menopause.

Connection Between Menopause and Breast Cancer

Hormone-positive breast cancers are primarily caused by estrogen and progesterone. As menopause approaches, the ovaries produce less of these hormones, leading to hot flashes, vaginal dryness, painful joints, and insomnia.

Additionally, those who experience menopause after 55 have an even greater risk of breast cancer due to prolonged exposure to estrogen and progesterone.

One study looked at women 55–74 with no history of breast cancer and found that those who experienced menopausal symptoms had a 40% to 60% lower risk of developing invasive ductal carcinoma and invasive lobular carcinoma compared to women who had no menopausal symptoms. These statistics were not influenced by hormone therapy use and were universal despite body mass index (BMI) or age. More research is needed to confirm these findings.

Prevalence

Although menopause and breast cancer are related to increasing age, there are other factors that can have an influence on whether breast cancer occurs after menopause. These factors include:

• Race: The average age of breast cancer diagnosis for Black women is 60 compared to 64 for White women. In addition, Black women are more likely to die from breast cancer than White women. The reasons for these disparities are not fully known but are multifactorial, including accessibility to health care and health insurance, and not necessarily related to genetic differences.
• Genetic mutations: Seven out of 10 women with a BRCA mutation will get breast cancer by age 80.
• Family history: Having a first-degree relative (mother, sister, or daughter) triples the risk of getting breast cancer.
• Dense breasts: Breast tissue that is fibroglandular and less fatty makes cancer hard to see on a mammogram, and this type of tissue is at a higher risk of developing cancer.
• Obesity: Older women who are overweight have a higher risk of getting breast cancer than those who do not have excess weight.

Hormone Therapy

Hormone therapy (HT) has been used for decades to ease the symptoms of menopause. However, it's been long blamed for causing breast cancer. The North American Menopause Society (NAMS) released the following data in 2022:

• Women with a uterus who take estrogen and progesterone have a slightly increased risk of breast cancer.
• Women without a uterus who took estrogen did not have an increased risk of breast cancer, and in long-term follow up, had a slightly decreased risk.
• Women with a family history of breast cancer did not have a further increased risk of breast cancer while on hormone therapy.

Hormone therapy may not be suitable for everyone. Talk to your healthcare provider about the risks and benefits.

Treatment and Management of Menopause and Breast Cancer

Breast cancer treatment can sometimes worsen symptoms of menopause. Hormone therapy to treat breast cancer decreases or stops the body's ability to produce certain hormones. The abrupt lack of estrogen and progesterone leads to increased hot flashes, vaginal dryness, painful joints, and insomnia. HT is not usually recommended to treat menopause symptoms with breast cancer.

The following are ways to manage menopause with breast cancer:

• Sleep in a cool room to reduce hot flashes.
• Use water-based lubricants and nonhormonal vaginal moisturizers to relieve vaginal dryness.
• Some healthcare providers may prescribe Vagifem (low-dose vaginal estrogen tablet) to improve vaginal health.
• Vaginal dilator therapy can improve pelvic floor muscles.
• Low-dose antidepressants may help with several side effects of menopause.

Talk to your healthcare provider about other ways to improve menopause symptoms if you have breast cancer.

Prevention

If you take hormone treatments for breast cancer, you will undergo menopause. However, you can reduce menopausal symptoms and decrease the risk of breast cancer by incorporating the following practices in your life:

• Stay on top of screening: Breast cancer is curable if caught early. Following your healthcare provider's recommendations for mammogram screening is vital.
• Reduce or eliminate alcohol: Alcohol consumption can elevate estrogen-related hormones and worsen hot flashes. In addition, just 1 to 1.5 ounces of alcohol daily increases the risk of breast cancer by 32%.
• Maintain a healthy weight: Obesity is associated with postmenopausal breast cancer; therefore, maintaining a healthy weight is key to breast cancer prevention.
• Exercise: Physical activity has been shown to reduce the risk of breast cancer by regulating insulin levels. Exercise also releases "feel good" chemicals that improve mood.
• Eat healthfully: Foods that reduce breast cancer risk include whole grains, vegetables, fruit, and legumes.

You can't control all the factors that affect the timing of menopause or affect your risk of breast cancer, but you can implement changes that can improve both menoapusal symptoms and lower your risk of breast cancer.

Summary

Although menopause does not directly cause breast cancer, aging is a key risk factor for breast cancer development. People who experience menopause after age 55 are more likely to get breast cancer than those who experience menopause at a younger age.

Risk factors, such as obesity, place postmenopausal women at a higher risk for breast cancer. Screening for breast cancer and lifestyle changes can improve menopausal symptoms and increase the odds of not getting breast cancer.

A Word From Verywell

If you experience menopause after age 55, you may be at increased risk for breast cancer. Although you may be unable to control all the factors that lead to postmenopausal breast cancer, you can reduce your risk through lifestyle changes. A plant-based diet, regular exercise, and routine breast cancer screening tests can decrease your risk. Talk to your healthcare provider about other ways to stay cancer-free after menopause.