Experts call for individualized approach to HRT after breast cancer

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Sarah Glynne, MBBS, BSc, and Jayant S. Vaidya, PhD, urge clinicians to move beyond blanket bans and support informed, patient-centered care.

In a recent discussion with Contemporary OB/GYN, Sarah Glynne, MBBS, BSc, GP menopause specialist at The Portland Hospital, and Jayant S. Vaidya, PhD, professor of surgery and oncology at the University College London, emphasized the importance of individualized, evidence-informed conversations between clinicians and patients regarding hormone replacement therapy (HRT) after breast cancer.

The pair discussed their recent publication and the upcoming MENO-ABC trial, both aimed at reframing how clinicians approach menopause management in breast cancer survivors. Glynne explained that the purpose of their work is not to promote HRT use after breast cancer, but rather to promote open, patient-centered dialogue about its potential risks and benefits. She noted that many women continue to experience significant menopausal symptoms that severely affect their quality of life, yet are frequently denied HRT without discussion. Many women in her studies reported being “shut down” by their clinicians when they raised the topic, highlighting a culture of caution that often leaves patients feeling dismissed.

The researchers advocate shifting away from a “blanket ban” approach and toward individualized care that considers each patient’s cancer recurrence risk, symptom burden, and preferences. Glynne stressed that women are capable of making informed decisions when provided with accurate, up-to-date information. Clinicians, she said, should act as guides rather than gatekeepers, supporting patients in evaluating whether HRT—or alternative treatments—aligns with their needs.

Vaidya added that while HRT use after breast cancer remains complex, the central message is to “let us discuss it.” The MENO-ABC trial, which is currently seeking funding, aims to rigorously study HRT’s safety and efficacy in this population while developing educational resources to help clinicians personalize care. The project will include global webinars and training materials to teach doctors how to assess candidates, titrate doses, and monitor outcomes.

The study has already generated widespread interest on social media, with physicians and patients reaching out to participate and share their experiences. Glynne noted that for many patients, this research represents the first time they have felt heard and validated regarding their menopausal challenges after breast cancer.

Vaidya underscored the value of clinical trials and randomization in advancing medical understanding, drawing parallels to historical shifts in breast cancer treatment. The ultimate goal, he said, is to generate high-quality evidence that can safely guide HRT decision-making, ensuring that future patients benefit from science-driven, individualized care rather than one-size-fits-all restrictions.

This video is part 2 of a 2-part series. Click here for part 1.

No relevant disclosures.

References

  1. Experts call for change of heart on hormone replacement therapy after breast cancer. University College London. September 30, 2025. Accessed October 1, 2025. https://www.eurekalert.org/news-releases/1100355.
  2. Glynne S, Simon J, Branson A, et al. Menopausal hormone therapy for breast cancer patients: what is the current evidence? Menopause. 2025. doi:10.1097/GME.0000000000002627

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