Menopause and Breast Cancer: Is There a Link?

Menopause is a term that people in their 40s and 50s who were born biologically female know all too well.

Defined as the end of your menstrual cycles and marked by symptoms like hot flashes, mood changes and more, it’s a time in life that brings up a lot of questions about your health.

One common question that doctors and other clinicians hear is if going into perimenopause (the time before you go into menopause) and menopause increases your risk for breast cancer.

“Perimenopause and menopause do not cause breast cancer,” says surgical oncologist Lori Alfonse, DO, Deputy Physician in Chief of Lehigh Valley Topper Cancer Institute. “However, there are certain factors, like when you start menopause and if you undergo hormone therapy for menopause symptoms, that can affect your risk.”

To help you better understand breast cancer and how it relates to menopause, Dr. Alfonse is sharing answers to common questions she hears:

One of the biggest risk factors for breast cancer is older age (which is when people typically enter perimenopause and menopause). As we get older, there are more opportunities for genetic mutations to take place in our cells, and our bodies are less capable of repairing the damage. This in turn can lead to cancer.

Other risk factors include:

• Being born biologically female
• Being overweight or obese
• Drinking alcohol
• Having a family history of breast cancer
• Having dense breast tissue (breasts that have more glandular, fibrous and/or connective tissue than fatty tissue)
• Having a history of taking birth control pills
• Going through more menstrual cycles /starting menopause after age 55
• Not breastfeeding
• Not having children
• Undergoing menopausal hormone therapy

MHT involves boosting the levels of certain hormones in your body that you can’t produce as easily after entering menopause.

While this can help with your menopause symptoms, it also can put you at higher risk for breast cancer, as having higher levels of these hormones (specifically estrogen) in your body increases your risk.

There is good news, though.

“Undergoing MHT for less than five years does not increase your breast cancer risk, and certain types of MHT are safer than others,” Dr. Alfonse says. “If you are struggling with your menopause symptoms, talk to your doctor about your options, which can include making lifestyle changes. If MHT is recommended, talk to your care team about the best options that offer the lowest risk.”

While some risk factors cannot be changed, others can be. The key to lowering your risk is making healthy lifestyle choices and changes, like:

• Being physically active
• Limiting your alcohol intake (no more than one drink per day)
• Maintaining a healthy weight
• Not smoking or quitting smoking

Along with taking steps to lower cancer risk, it’s also important for people born biologically female to perform breast self-exams once a month and talk to their doctor about when to start getting annual screening mammograms.

“Mammograms and supplemental screenings are important for everyone, even people who minimize their risk for breast cancer as much as possible,” Dr. Alfonse says. “If you are at average risk for breast cancer and were born biologically female, you should start getting a mammogram once a year at age 40.”