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Objective  By the 1990s it became popular for women to use hormone therapy (HT) to ease menopause symptoms. Bioidentical estrogen and progesterone are supplements whose molecular structures are identical to what is made in the human body, while synthetic supplements are ones whose structures are not. After the Women’s Health Initiative found that the combined use of the synthetics conjugated equine estrogen (CEE) and medroxyprogesterone acetate (MPA) increased breast cancer risk, prescriptions for synthetic HT declined considerably. Since then there has been an increased interest in bioidentical HT; today there are a plethora of websites touting their benefits. However, no peer-reviewed articles support these claims. We performed a retrospective study with the objective of verifying the  hypothesis that bioidentical HT is associated with decreased breast cancer risk than CEE & MPA .    Methods  We searched The Northwestern Medicine Enterprise Data Warehouse for women who initiated HT use after age 50. Women who did not take any HT drug after age 50 served as controls. Nine HT protocols were investigated for breast cancer risk.    Results  Significant results include  CEE Alone  is associated with decreased breast cancer risk (HR = 0.31),  Other Synthetic Estrogen Alone  is associated with increased breast cancer risk (HR = 1.49),  Bioidentical Estrogen Alone  is associated with decreased breast cancer risk(HR = 0.65),  CEE & MPA  is associated with reduced breast cancer risk (HR = 0.43), and  CEE & MPA  is associated with reduced breast cancer risk relative to  Bioidentical Estrogen & Progesterone  (HR = 0.25).    Discussion  Our results indicate  CEE & MPA  is superior to bioidentical HT as far as breast cancer risk. Furthermore, this combination is associated with decrease of breast cancer risk, contrary to previous findings. Additional retrospective studies are needed to confirm our results.

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Conjugated equine estrogen and medroxyprogesterone acetate are associated with decreased risk of breast cancer relative to bioidentical hormone therapy and controls