Despite all the hype as a non-chemo therapeutic option for many breast cancers, hormone deprivation isn’t loved by women one and all. In fact, many don’t love it so much they simply stop taking it. What can be done to increase compliance? Give hormones back to their vaginas. A large UK population-based study examined nearly 50K women with breast cancer including 5% (n=2551) using vaginal estrogen therapy. Sure a lot of disease details were lacking, but there was no signal of higher breast cancer mortality among these vaginal estrogen users (HR 0.77). Unless or until contrary evidence emerges, it is likely very safe to offer hormone-deprived women with breast cancer vaginal estrogen as a means to ameliorate vaginal pruritus and burning, dyspareunia, and urinary incontinence. | McVicker, JAMA Oncol 2023
