Women who carry BRCA1 or BRCA2 gene mutations often worry about getting breast or ovarian cancer.
These mutations can significantly increase their risk. To reduce this risk, doctors often suggest a surgery called oophorectomy.
This means removing the ovaries and fallopian tubes, usually at a younger age than normal menopause. While this helps lower the risk of cancer, it brings on early menopause.
Early menopause can cause hot flashes, mood swings, sleep problems, and other uncomfortable symptoms.
To help with these, doctors may recommend menopausal hormone therapy (MHT), which gives the body hormones like estrogen or progesterone. However, many women avoid taking MHT because they’re afraid it will increase their chances of getting breast cancer.
A new study presented at the San Antonio Breast Cancer Symposium in December 2025 brings some good news. The study shows that MHT is not linked to a higher risk of breast cancer in women with BRCA1 or BRCA2 mutations. This research was led by Dr. Joanne Kotsopoulos from the Women’s College Hospital and the University of Toronto.
Dr. Kotsopoulos said that many women suffer needlessly because they avoid MHT, thinking it is unsafe. She believes it’s important to offer safe ways to manage the symptoms of early menopause, especially when it’s caused by surgery.
She also pointed out that many earlier studies about MHT and breast cancer were done on women who did not have BRCA mutations. This made it unclear whether the results applied to women with these specific genetic risks.
To get clear answers, the researchers followed a group of women with BRCA1 or BRCA2 mutations. All of them had gone through menopause, mostly due to surgery. The researchers created 676 matched pairs of women. In each pair, one woman took MHT and the other did not. They were matched by their gene type, birth year, and age at menopause.
The women were between 22 and 76 years old, and their average age was about 44. Over the next 5.6 years, the researchers checked how many women in each group developed breast cancer. They found that only 87 women who took MHT got breast cancer, compared to 128 women who didn’t take MHT.
The researchers also looked at different types of MHT. Most hormone treatments didn’t seem to raise or lower the risk. But estrogen-only therapy was linked to a much lower risk—63% less.
Even more interesting, among the women who used a mix of conjugated estrogen and bazedoxifene, none developed breast cancer. Though this group was small, the result is promising and may lead to new research.
The results were similar for both BRCA1 and BRCA2 gene carriers. This means that MHT may be safe for both groups. Dr. Kotsopoulos says doctors should take a personalized approach and consider MHT when helping women manage menopause, especially if the symptoms are affecting their quality of life.
Still, the study had some limits. The follow-up period was just over five years, and some subgroups had only a small number of patients. But overall, the findings give hope to many women with BRCA mutations who want relief from menopause symptoms without adding to their cancer risk.
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