All women receiving hormone therapy (HT) should undergo a medical checkup every year. At that time, the doctor or nurse will perform a breast exam and order a mammogram (a special X-ray picture of the breasts) to check for masses in the breasts that might possibly be cancer. At, or even prior to these check-ups, a woman should discuss her bleeding pattern with her physician to be sure it is within the expected pattern for her specific type of hormone therapy (HT). Other routine screening evaluations may also be performed at this annual check-up.
Testing for hormone receptors is important because the results help you and your doctor decide whether the cancer is likely to respond to hormonal therapy or other treatments. Hormonal therapy includes medications that either (1) lower the amount of estrogen in your body or (2) block estrogen from supporting the growth and function of breast cells. If the breast cancer cells have hormone receptors, then these medications could help to slow or even stop their growth. If the cancer is hormone-receptor-negative (no receptors are present), then hormonal therapy is unlikely to work. You and your doctor will then choose other kinds of treatment.
Estrogen helps reduce the rate of bone loss that occurs during normal bone remodeling. Normally there is a balance in the activity of the cells that break down bone and the cells that build it back up. By decreasing the activity of the cells that break down bone, estrogen allows the cells that build bone to have a greater overall effect. Once estrogen levels drop, this balance shifts.
While hormone therapy has been shown to decrease hip and vertebral fractures, it may also increase your risk of other health conditions, such as invasive breast cancer, stroke and blood clots. Discuss the risks and benefits of available treatments with your health care professional.