[Hormone replacement therapy in breast cancer survivors: the Israeli Society for Clinical Oncology and Radiotherapy policy letter].

The Israeli Society for Clinical Oncology and Radiotherapy requested that experts in breast cancer therapy assess the Society's policy regarding the use of hormone replacement therapy (HRT) in breast cancer survivors. The following recommendations are based on updated literature, which is limited since it summarizes only retrospective data. There is currently no evidence of an increased risk of breast cancer recurrence, death attributable to cancer, or overall mortality among breast cancer survivors who use HRT. We therefore recommend that there is no need to avoid HRT in women with menopausal symptoms who are interested in receiving such treatment, as long as ovarian ablation does not play a major role in their adjuvant therapy. Women should be informed about the limitations of available data. There are some concerns regarding the use of HRT in patients whose tumors developed while undergoing HRT and in such cases treatment should be reserved only for those with severe menopausal symptoms. For women with milder symptoms or those who are not interested in HRT, other treatment options should be outlined. The policy should be updated according to future publication of results from ongoing randomized prospective studies.