The issues involved

The link between HRT and breast cancer is well established but the findings of the Cancer Research UK study suggest we have been underestimating the risk, particularly with combination HRT (preparations containing both an oestrogen and progestagen) - the most commonly prescribed form.

The study has also shown that the risk of breast cancer starts to rise much earlier than doctors thought - conventional wisdom had it that there is no significant rise in breast cancer risk in women taking HRT for less than five years but Professor Beral's team found a worrying rise in rates after only one to two years.

Who should be concerned?

Around a third of middle-aged women in the UK take HRT but recent scares have left many of them anxious and the number is falling fast, albeit not as quickly as in America where one in three women on combined HRT have stopped it in the last 12 months. All women who have been on HRT for more than 12 months are potentially at risk, but the risk is highest on combined forms of HRT.

What do I do if I want to stop it?

There is no need to panic. Waiting a few weeks, or even a few months, will have no significant effect on your risk of developing breast cancer. Give your doctor time to digest the study findings and review the latest guidance from the Committee on Safety of Medicines.

You can stop taking HRT but it is best to wean yourself off slowly under medical guidance to reduce any withdrawal symptoms (mainly hot flushes).

What are the alternatives?

If you are concerned, your GP may be able to offer you a switch to a lower risk type of HRT or a different form of treatment altogether. Hot flushes may respond to alternative therapies such as black cohosh (though there have been some concerns about its safety), vaginal and urinary problems may be helped by HRT creams and pessaries (almost risk free), and thinning bones by osteoporosis treatments.