Q: Does localized hormone use increase breast cancer risk?

Localized estrogen is not thought to be absorbed systemically, which means that blood estrogen levels remain in the menopausal range; if there is any absorption, it is scant. At that level, it does not increase risks of breast cancer. Unfortunately, the "prescribing information" (PI) for localized hormones is required to be the same as for all estrogens, although the risks are significantly different from those of systemic estrogens.

Last month, I attended the North American Menopause Society (NAMS) annual meeting, where I heard that a request has been filed with the FDA to amend the PI to fit more accurately what's known about localized estrogen use.