Why is there increased morbidity and mortality in those that don’t take ERT? This is simply because there is an increase in breast cancer recurrence in prior cancer survivors, around 350/10,000 women (that don’t take HRT). This does not mean, though, that taking estrogen increases the risk. However, those that do take BHRT do benefit from HRT despite the resistance from oncologists. The increase in breast cancer recurrence at baseline should not be extrapolated to what happens with treatment. In every study, treatment with estrogen decreases breast cancer risk. Observation at baseline does not prove causation. The most recent issue of JAMA proved that the only drug to decrease breast cancer mortality was estrogen! It was not a SERM or AI.