HUBUNGAN ANTARA HORMONE REPLACEMENT THERAPY DENGAN RISIKO KANKER PAYUDARA PADA WANITA PASCAMENOPAUSE
THE ASSOCIATION BETWEEN HORMONE REPLACEMENT THERAPY AND BREAST CANCER RISK IN POSTMENOPAUSAL WOMEN
Abstract
Kanker payudara adalah penyebab utama kematian akibat kanker pada wanita, dengan insidensi global meningkat akibat faktor genetik, lingkungan, hormonal, dan gaya hidup, di mana estrogen dan progesteron mendorong proliferasi sel payudara melalui reseptor estrogen yang dapat memicu transformasi malignan. Pada wanita pascamenopause, penurunan estrogen diatasi dengan Hormone Replacement Therapy (HRT), yang meredakan gejala menopause dan mencegah osteoporosis, namun meningkatkan risiko kanker payudara. Kajian literatur ini meninjau hubungan HRT dengan risiko kanker payudara berdasarkan bukti epidemiologis, mekanisme biologis, dan temuan klinis. Metode yang digunakan adalah narrative review melalui pencarian artikel di PubMed, ScienceDirect, dan Google Scholar (2019–2025) dengan kata kunci “hormone replacement therapy”, “breast cancer risk”, dan “HRT breast cancer”, mencakup RCT, kohort, atau studi prospektif. Hasil telaah menunjukkan bahwa terapi estrogen tunggal menurunkan risiko kanker payudara 22% (HR 0.78; 95% CI 0.65–0.93) pada wanita pascahisterektomi, sedangkan kombinasi estrogen–progestin meningkatkan risiko 28% (HR 1.28; 95% CI 1.13–1.45). Studi kohort mengonfirmasi peningkatan risiko pada penggunaan kombinasi lebih dari lima tahun, terutama pada wanita dengan indeks massa tubuh rendah dan densitas payudara tinggi. Temuan ini menunjukkan bahwa peningkatan risiko terutama disebabkan oleh komponen progestin, sementara estrogen sendiri memiliki efek minimal. Stratifikasi risiko individu penting dalam mempertimbangkan manfaat dan risiko jangka panjang terapi HRT.
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