ASSOCIATION BETWEEN HORMONE REPLACEMENT THERAPY AND THE RISK OF BREAST CANCER IN WOMEN WITH A FAMILY HISTORY OF THE DISEASE: A SYSTEMATIC REVIEW OF THE LITERATURE

Abstract

Introduction: Breast cancer is a major cause of morbidity and mortality among women and is influenced by hormonal and genetic factors. Hormone replacement therapy (HRT), used to treat menopausal symptoms, has been associated with increased risk, although the role of family history remains uncertain. Objectives: To analyze the association between HRT use and the risk of breast cancer in postmenopausal women, focusing on those with a family history and the possible interaction between these factors. Methodology: A qualitative systematic review conducted in accordance with PRISMA 2020 guidelines. Searches were performed in PubMed, LILACS, and BDTD, including studies published between 2015 and 2025. Observational studies and clinical trials assessing HRT and breast cancer risk were included, considering subgroups with family history or genetic predisposition. Results: Seven studies were included. Overall, HRT was associated with increased risk, particularly with combined therapy and long-term use. Family history was identified as an independent risk factor. However, no consistent evidence of a synergistic interaction was found, suggesting a predominantly additive effect. Study heterogeneity limits stronger conclusions. Conclusion: HRT is associated with increased risk under certain conditions, while family history remains an independent factor. There is no clear evidence of a proportional combined effect, highlighting the need for individualized assessment and further research on the topic.