Tamara Hussong Milagre, President of EVITA and ePAG Representative at European Reference Network GENTURIS, shared a post by Inherited Cancer Registry (ICARE), adding:
” Reading this new JAMA Network Open study on HRT after RRBSO in women with BRCA pathogenic variants, I couldn’t help but reflect on my own decision back in 2010, a decision that shaped not only my health, but also my understanding of what true doctor‑patient partnership looks like.
In 2010, long before evidence like this was available, I chose not only to undergo risk‑reducing bilateral salpingo‑oophorectomy but also a total hysterectomy. My reasoning was simple and deeply personal: The combined HRT with progestin is only necessary to lower your risk for endometrial cancer if you retain the uterus. So, without removing the uterus, I would be required to take combined estrogen‑progestin HRT, whereas a hysterectomy would allow me to use estrogen‑only HRT, which at the time already appeared not to increase breast cancer risk.
This was not the standard recommendation then, and, remarkably, it still isn’t today. Guidelines continue to advise against hysterectomy in BRCA carriers unless medically indicated. But I was fortunate. My surgeon listened. She (!) didn’t hide behind rigid protocols. She understood that informed choice means respecting a woman’s values, risk perception, and long‑term health priorities.
Sixteen years later, evidence is finally catching up. The study shows that estrogen‑only HRT after RRBSO is not associated with increased breast cancer risk and may even reduce it in BRCA1 carriers.
For me, this reinforces something I have advocated for throughout my work in hereditary cancer: evidence evolves, but the right to informed, individualized decision‑making must be constant.
Women deserve clinicians who are willing to discuss options openly, even when they fall outside traditional pathways. They deserve space to weigh risks and benefits in the context of their own lives. And they deserve to be partners, not passengers, in decisions that shape their future health.
This article is an important step forward. But the conversation about autonomy, shared decision‑making, and personalized prevention is far from over.”
Quoting Inherited Cancer Registry (ICARE)‘s post:
“A new study shows that estrogen-only hormone replacement therapy (HRT) after ovary removal can LOWER breast cancer risk in women carrying the BRCA1 genetic mutation.
What were the findings?
- Women using HRT had many fewer cases of breast cancer (11% vs 19%)
- The longer women used estrogen-only HRT, the greater the protection
- Every additional year of use lowered risk by about 10%
Why is this important?
- This is another study to show that HRT appears safe to take in BRCA1 carriers after removing their ovaries (i.e., surgical menopause)
- Estrogen is important in premenopausal women for bone health, cardiovascular health, etc.
- If you have BRCA1/BRCA2 mutations, talk to your doctor about what options might be right for you.
Reference: Regev-Sadeh et al. JAMA Network Open. 2026;9(4):e265648. PMID: 41949865.
Through ICARE, we aspire to share cancer-related information that may be of interest. If you have questions or clarifications, please direct them to your healthcare provider.”