https://orcid.org/0000-0002-1097-9780
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Jennifer Merrill, Letter to the Editor From Merrill: “Breast Cancer is Increased in Women With Primary Ovarian Insufficiency”, The Journal of Clinical Endocrinology & Metabolism, Volume 110, Issue 5, May 2025, Pages e1711–e1712, https://doi.org/10.1210/clinem/dgae884
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Dear Editor,
The recent article by Allen-Brady et al (1) asserts that all women with primary ovarian insufficiency (POI) face increased breast cancer risk. This titular claim appears too broad, particularly given previous research indicating a lower breast cancer risk in women with POI and earlier menopause (2, 3).
Physiologic hormone replacement therapy (HRT) is the mainstay of treatment for POI, so there is potential harm from overstating breast cancer risk. Many women with POI were negatively affected by the change in prescribing patterns after publication of the Women's Health Initiative study, which linked estrogen and progestogen replacement with increased breast cancer risk in much older women (4). At the time, rates of hormone replacement plummeted. Many women were deprived of HRT and consequently developed severe osteoporosis and strokes by their early 50s due to lack of treatment. HRT alleviates symptoms, restores bone mineral density, and improves endothelial dysfunction for women with POI (4).
