Ep.4 HRT, Menopause and Breast Cancer

In this episode, Dr Jennifer McBride (GP with a specialist interest in Sexual Medicine and Reproductive Health and Sefton GP Clinical Lead for Gynaecology at the Cheshire & Merseyside Cancer Alliance) joins Miss Sonia Bathla (Consultant Oncoplastic Breast Surgeon at the Burney Breast Unit, Mersey and West Lancashire Teaching Hospitals NHS Trust) to discuss how patients with menopausal symptoms commonly present in primary care, which symptoms matter most to them, and what clinical assessment is required. They clarify the relationship between HRT and breast cancer risk, including management options and when referral is appropriate. They also explore the challenges of managing treatment-related menopausal symptoms in women with breast cancer, including patient concerns, available treatment options, and contraceptive choices, including hormonal methods. Practical resources are included to support clinical practice and deepen listeners’ understanding.

Here are the links to the resources mentioned in the episode:
1. British Menopause Society. Fast Facts: HRT and Breast Cancer Risk (Sep 2025) 
https://thebms.org.uk/wp-content/uploads/2025/09/12-NEW-BMS-ToolsforClinicians-Fast-Facts-HRT-and-Beast-Cancer-Risk-SEPT2025-B.pdf  
 
2. British Menopause Society 
Short videos on : HRT & Risk Of Breast Cancer, HRT & breast cancer: overall risks and benefits,  
Post Cancer Treatments 
https://thebms.org.uk/publications/bms-tv/ 
 
3. Update on Menopause Hormone Therapy: Current Indications and Unanswered Questions. Mukherjee A, Davis SR. Clinical Endocrinology 2025.  
https://onlinelibrary.wiley.com/doi/10.1111/cen.15211?msockid=09b63fd088756a85080429af893b6bd7  
 
4. British Menopause Society. Consensus statement: The benefits and risks of HRT before and after a breast cancer diagnosis. Updated September 2025.  
https://thebms.org.uk/publications/consensus-statements/risks-and-benefits-of-hrt-before-and-after-a-breast-cancer-diagnosis/

5. NICE CG164, Familial Breast Cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer: Section 1.7.10 Hormone Replacement Therapy) 
https://www.nice.org.uk/guidance/cg164/chapter/Recommendations  
 
6. British Menopause Society. Consensus statement: Management of oestrogen deficiency symptoms and arthralgia in women treated for early breast cancer. Updated September 2025.  
https://thebms.org.uk/wp-content/uploads/2025/09/03-BMS-ConsensusStatement-Management-of-symptoms-after-breast-cancer-SEPT2025-C.pdf  
 
7. NICE NG23: Discussion aid - HRT and likelihood of some medical conditions (includes breast cancer) 
https://www.nice.org.uk/guidance/ng23/resources/incidence-of-medical-conditions-with-and-without-hrt-a-discussion-aid-pdf-13553199901  
 
8. NICE NG101 – Early and locally advanced breast cancer: diagnosis and management, Section 1.14.20 – 25 Menopausal Symptoms. 
https://www.nice.org.uk/guidance/ng101/chapter/Recommendations#management-of-treatment-side-effects-and-menopausal-symptoms  
 
9. British Menopause Society. BMS Tool for Clinicians: Prescribable alternatives to HRT: updated March 2026 
https://thebms.org.uk/wp-content/uploads/2026/03/02-NEW-BMS-Prescribable-alternatives-to-HRT-MARCH2026-A.pdf 
 
10. NICE: Clinical Knowledge Series: Menopause: Prescribing Information: Fezolinetant (May 2026) 
https://cks.nice.org.uk/topics/menopause/prescribing-information/fezolinetant/  
 
11. Contraception and Breast Cancer, FSRH Guidance: The College of Sexual & Reproductive Healthcare, 2023 
https://www.cosrh.org/Public/Public/Standards-and-Guidance/Contraception-and-Breast-Cancer.aspx