{"id":1675,"date":"2025-07-01T12:30:53","date_gmt":"2025-07-01T15:30:53","guid":{"rendered":"https:\/\/sottopellebrasil.com.br\/sou-medico\/?p=1675"},"modified":"2025-07-01T14:01:50","modified_gmt":"2025-07-01T17:01:50","slug":"reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu","status":"publish","type":"post","link":"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/","title":{"rendered":"Reposi\u00e7\u00e3o Hormonal ap\u00f3s C\u00e2ncer de Mama: o que h\u00e1 de novo?"},"content":{"rendered":"\n
A terapia de reposi\u00e7\u00e3o hormonal (TRH) na menopausa, em mulheres com hist\u00f3rico de c\u00e2ncer de mama, continua sendo um dos temas mais complexos e discutidos na endocrinologia ginecol\u00f3gica. Durante muito tempo, prevaleceu uma abordagem extremamente conservadora, centrada no medo da recidiva. No entanto, novas evid\u00eancias e diretrizes permitem hoje uma avalia\u00e7\u00e3o mais personalizada e equilibrada.<\/p>\n\n\n\n
Entendendo a complexidade: o papel da biologia tumoral<\/strong><\/h2>\n\n\n\n
Nem todos os c\u00e2nceres de mama respondem da mesma forma aos horm\u00f4nios. Por isso, \u00e9 essencial compreender a histologia e o perfil molecular do tumor:<\/p>\n\n\n\n
Subtipo tumoral<\/strong><\/td>
Receptores hormonais<\/strong><\/td>
Implica\u00e7\u00e3o para TRH<\/strong><\/td><\/tr>
Carcinoma ductal infiltrante RH+<\/td>
ER+\/PR+<\/td>
Contraindica TRH sist\u00eamica<\/td><\/tr>
Carcinoma HER2+ puro<\/td>
Sem express\u00e3o hormonal<\/td>
Avalia\u00e7\u00e3o caso a caso<\/td><\/tr>
Triple-negative (ER-, PR-, HER2-)<\/td>
Aus\u00eancia de receptores<\/td>
Maior abertura para discutir TRH<\/td><\/tr>
Carcinoma in situ (DCIS\/LCIS) curado<\/td>
Dependente do subtipo<\/td>
Pode ser considerado<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
O que dizem as principais evid\u00eancias?<\/strong><\/h2>\n\n\n\n
\n
A metan\u00e1lise CGHFBC publicada no The Lancet<\/em> (2019) apontou aumento no risco de recidiva com o uso cont\u00ednuo de TRH combinada em mulheres com c\u00e2ncer RH+.<\/li>\n\n\n\n
O estrog\u00eanio isolado demonstrou risco bem menor, principalmente em mulheres histerectomizadas.<\/li>\n\n\n\n
Uma revis\u00e3o integrativa publicada em 2025 (Acervo Sa\u00fade<\/em>) mostrou que a dura\u00e7\u00e3o e o tipo de horm\u00f4nio utilizado influenciam diretamente esse risco.<\/li>\n<\/ul>\n\n\n\n
Novas diretrizes: mais individualiza\u00e7\u00e3o<\/strong><\/h2>\n\n\n\n
As diretrizes NICE (2024) e BMS (2024) prop\u00f5em uma abordagem mais flex\u00edvel:<\/p>\n\n\n\n
\n
A TRH sist\u00eamica permanece contraindicada em c\u00e2nceres de mama RH+ ativos ou recentes.<\/li>\n\n\n\n
Pode ser discutida em casos de c\u00e2ncer triple-negative ou HER2+, curado h\u00e1 muitos anos, desde que com aval do oncologista e equipe especializada.<\/li>\n<\/ul>\n\n\n\n
Segundo NICE e BMS, o estrog\u00eanio vaginal de baixa dose n\u00e3o aumenta o risco de recidiva<\/strong> em mulheres com c\u00e2ncer de mama RH+.<\/li>\n\n\n\n
Um estudo apresentado na ASCO 2025 mostrou que mulheres com >65 anos que usaram creme vaginal apresentaram redu\u00e7\u00e3o da mortalidade<\/strong>.<\/li>\n\n\n\n
Pode ser indicado para sintomas urogenitais como secura vaginal, dispareunia e infec\u00e7\u00f5es urin\u00e1rias recorrentes, sempre com acompanhamento multidisciplinar.<\/li>\n<\/ul>\n\n\n\n
Dicas pr\u00e1ticas para a conduta cl\u00ednica<\/strong><\/h2>\n\n\n\n
\n
C\u00e2ncer de mama RH+ ativo ou recente: contraindica\u00e7\u00e3o formal<\/strong> \u00e0 TRH sist\u00eamica.<\/li>\n\n\n\n
Triple-negative, HER2+ puro ou DCIS curado: podem permitir avalia\u00e7\u00e3o individualizada<\/strong>.<\/li>\n\n\n\n
Estrog\u00eanio vaginal local (baixa dose): seguro mesmo em RH+<\/strong>, com aval oncol\u00f3gico.<\/li>\n\n\n\n
A decis\u00e3o terap\u00eautica deve ser compartilhada e multidisciplinar<\/strong>, considerando riscos, benef\u00edcios e qualidade de vida da paciente.<\/li>\n<\/ul>\n\n\n\n
Refer\u00eancias:<\/strong><\/h2>\n\n\n\n
\n
NICE. Menopause: identification and management (NG23). 2024.<\/li>\n\n\n\n
British Menopause Society (BMS). Consensus Statement, 2024.<\/li>\n\n\n\n
The Lancet. Type and timing of menopausal hormone therapy and breast cancer risk. 2019.<\/li>\n\n\n\n
Acervo Sa\u00fade. Terapia hormonal na menopausa e c\u00e2ncer de mama: revis\u00e3o integrativa. 2025.<\/li>\n\n\n\n
Reuters Health. Older breast cancer patients using estrogen cream live longer. 2025.<\/li>\n\n\n\n
The Times. Menopausal cancer survivors offered HRT under new guidance. 2025.<\/li>\n<\/ul>\n\n\n\n
<\/p>\n\n\n\n<\/figure>\n\n\n\n
Artigo escrito pelo Diretor Cient\u00edfico da SottoPelle Brasil, Dr. Francisco Tostes.<\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"
A terapia de reposi\u00e7\u00e3o hormonal (TRH) na menopausa, em mulheres com hist\u00f3rico de c\u00e2ncer de mama, continua sendo um dos temas mais complexos e discutidos na [\u2026]<\/span><\/p>\n","protected":false},"author":1,"featured_media":1676,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-1675","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"yoast_head":"\nReposi\u00e7\u00e3o Hormonal ap\u00f3s C\u00e2ncer de Mama: o que h\u00e1 de novo? - SottoPelle Brasil | Sou M\u00e9dico<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Reposi\u00e7\u00e3o Hormonal ap\u00f3s C\u00e2ncer de Mama: o que h\u00e1 de novo? - SottoPelle Brasil | Sou M\u00e9dico\" \/>\n<meta property=\"og:description\" content=\"A terapia de reposi\u00e7\u00e3o hormonal (TRH) na menopausa, em mulheres com hist\u00f3rico de c\u00e2ncer de mama, continua sendo um dos temas mais complexos e discutidos na [\u2026]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/\" \/>\n<meta property=\"og:site_name\" content=\"SottoPelle Brasil | Sou M\u00e9dico\" \/>\n<meta property=\"article:published_time\" content=\"2025-07-01T15:30:53+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-07-01T17:01:50+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-content\/uploads\/sites\/4\/2025\/07\/woman-with-pink-ribbon-symbol-of-breast-cancer-awa-2024-11-07-13-21-28-utc-scaled.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"2560\" \/>\n\t<meta property=\"og:image:height\" content=\"1708\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/\",\"url\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/\",\"name\":\"Reposi\u00e7\u00e3o Hormonal ap\u00f3s C\u00e2ncer de Mama: o que h\u00e1 de novo? - SottoPelle Brasil | Sou M\u00e9dico\",\"isPartOf\":{\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-content\/uploads\/sites\/4\/2025\/07\/woman-with-pink-ribbon-symbol-of-breast-cancer-awa-2024-11-07-13-21-28-utc-scaled.jpg\",\"datePublished\":\"2025-07-01T15:30:53+00:00\",\"dateModified\":\"2025-07-01T17:01:50+00:00\",\"author\":{\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/#\/schema\/person\/e2b6ecc9896358cdcef4d685d394b1aa\"},\"breadcrumb\":{\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/#breadcrumb\"},\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/#primaryimage\",\"url\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-content\/uploads\/sites\/4\/2025\/07\/woman-with-pink-ribbon-symbol-of-breast-cancer-awa-2024-11-07-13-21-28-utc-scaled.jpg\",\"contentUrl\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-content\/uploads\/sites\/4\/2025\/07\/woman-with-pink-ribbon-symbol-of-breast-cancer-awa-2024-11-07-13-21-28-utc-scaled.jpg\",\"width\":2560,\"height\":1708},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"In\u00edcio\",\"item\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Reposi\u00e7\u00e3o Hormonal ap\u00f3s C\u00e2ncer de Mama: o que h\u00e1 de novo?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/#website\",\"url\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/\",\"name\":\"SottoPelle Brasil | Sou M\u00e9dico\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"pt-BR\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/#\/schema\/person\/e2b6ecc9896358cdcef4d685d394b1aa\",\"name\":\"admin\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/6ae7c08c9df737ddc9aeff85eabc0aba3d939593132f05c19388847e6a47af3c?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/6ae7c08c9df737ddc9aeff85eabc0aba3d939593132f05c19388847e6a47af3c?s=96&d=mm&r=g\",\"caption\":\"admin\"},\"sameAs\":[\"https:\/\/sottopellebrasil.com.br\"],\"url\":\"https:\/\/sottopellebrasil.com.br\/sou-medico\/author\/admin\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Reposi\u00e7\u00e3o Hormonal ap\u00f3s C\u00e2ncer de Mama: o que h\u00e1 de novo? - SottoPelle Brasil | Sou M\u00e9dico","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/","og_locale":"pt_BR","og_type":"article","og_title":"Reposi\u00e7\u00e3o Hormonal ap\u00f3s C\u00e2ncer de Mama: o que h\u00e1 de novo? - SottoPelle Brasil | Sou M\u00e9dico","og_description":"A terapia de reposi\u00e7\u00e3o hormonal (TRH) na menopausa, em mulheres com hist\u00f3rico de c\u00e2ncer de mama, continua sendo um dos temas mais complexos e discutidos na [\u2026]","og_url":"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/","og_site_name":"SottoPelle Brasil | Sou M\u00e9dico","article_published_time":"2025-07-01T15:30:53+00:00","article_modified_time":"2025-07-01T17:01:50+00:00","og_image":[{"width":2560,"height":1708,"url":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-content\/uploads\/sites\/4\/2025\/07\/woman-with-pink-ribbon-symbol-of-breast-cancer-awa-2024-11-07-13-21-28-utc-scaled.jpg","type":"image\/jpeg"}],"author":"admin","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"admin","Est. tempo de leitura":"3 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/","url":"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/","name":"Reposi\u00e7\u00e3o Hormonal ap\u00f3s C\u00e2ncer de Mama: o que h\u00e1 de novo? - SottoPelle Brasil | Sou M\u00e9dico","isPartOf":{"@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/#website"},"primaryImageOfPage":{"@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/#primaryimage"},"image":{"@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/#primaryimage"},"thumbnailUrl":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-content\/uploads\/sites\/4\/2025\/07\/woman-with-pink-ribbon-symbol-of-breast-cancer-awa-2024-11-07-13-21-28-utc-scaled.jpg","datePublished":"2025-07-01T15:30:53+00:00","dateModified":"2025-07-01T17:01:50+00:00","author":{"@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/#\/schema\/person\/e2b6ecc9896358cdcef4d685d394b1aa"},"breadcrumb":{"@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/#breadcrumb"},"inLanguage":"pt-BR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/"]}]},{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/#primaryimage","url":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-content\/uploads\/sites\/4\/2025\/07\/woman-with-pink-ribbon-symbol-of-breast-cancer-awa-2024-11-07-13-21-28-utc-scaled.jpg","contentUrl":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-content\/uploads\/sites\/4\/2025\/07\/woman-with-pink-ribbon-symbol-of-breast-cancer-awa-2024-11-07-13-21-28-utc-scaled.jpg","width":2560,"height":1708},{"@type":"BreadcrumbList","@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/reposicao-hormonal-apos-cancer-de-mama-ainda-e-um-tabu\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"In\u00edcio","item":"https:\/\/sottopellebrasil.com.br\/sou-medico\/"},{"@type":"ListItem","position":2,"name":"Reposi\u00e7\u00e3o Hormonal ap\u00f3s C\u00e2ncer de Mama: o que h\u00e1 de novo?"}]},{"@type":"WebSite","@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/#website","url":"https:\/\/sottopellebrasil.com.br\/sou-medico\/","name":"SottoPelle Brasil | Sou M\u00e9dico","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/sottopellebrasil.com.br\/sou-medico\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"pt-BR"},{"@type":"Person","@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/#\/schema\/person\/e2b6ecc9896358cdcef4d685d394b1aa","name":"admin","image":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/sottopellebrasil.com.br\/sou-medico\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/6ae7c08c9df737ddc9aeff85eabc0aba3d939593132f05c19388847e6a47af3c?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/6ae7c08c9df737ddc9aeff85eabc0aba3d939593132f05c19388847e6a47af3c?s=96&d=mm&r=g","caption":"admin"},"sameAs":["https:\/\/sottopellebrasil.com.br"],"url":"https:\/\/sottopellebrasil.com.br\/sou-medico\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/posts\/1675","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/comments?post=1675"}],"version-history":[{"count":3,"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/posts\/1675\/revisions"}],"predecessor-version":[{"id":1679,"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/posts\/1675\/revisions\/1679"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/media\/1676"}],"wp:attachment":[{"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/media?parent=1675"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/categories?post=1675"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-json\/wp\/v2\/tags?post=1675"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
![\"\"](\"https:\/\/sottopellebrasil.com.br\/sou-medico\/wp-content\/uploads\/sites\/4\/2025\/04\/WhatsApp-Image-2025-04-10-at-18.43.14-150x150.jpeg\")
<\/figure>\n\n\n\n