This narrative review analyses the customization of Menopause Hormone Therapy in the context of breast cancer risk in women with premature ovarian insufficiency (POI) and with menopause at a normal age. Women with Idiopathic POI, FMR-1 premutation or Turner syndrome, if left untreated, may have lower breast cancer risk compared to the healthy age-matched female population. These women should be treated with MHT until the age of 50, as the risk of breast cancer is equal to that of normally menstruating women. Carriers of BRCA 1 & 2 mutation after risk-reducing bilateral salpingo-oophorectomy (RRSO), without a personal history of cancer, have an increased breast cancer risk, but may probably be treated with MHT till the age of 50. POI resulting from endometriosis or cancer related treatment is discussed in a separate paper in this issue.

In peri- and postmenopausal women with menopausal symptoms and/or risk factors for osteoporosis in need of MHT, the individual breast cancer risk can be evaluated using internet-based calculators. In most women the 5-year-breast cancer risk is low (<3%) and MHT is a safe option. MHT should be prescribed with caution in women who have an intermediate risk (3–6%) and should not be prescribed in those who have a high risk of breast cancer (>6%). Oestrogen-only MHT and oestrogen-progestogen MHT containing micronized progesterone or dydrogesterone are associated with lower breast cancer risk compared to other combined MHT regimens.

这篇叙述性综述分析了在卵巢早衰 (POI) 和正常年龄绝经的女性患乳腺癌风险的背景下，更年期激素治疗的定制。与年龄匹配的健康女性人群相比，患有特发性 POI、FMR-1 前突变或 Turner 综合征的女性如果不接受治疗，患乳腺癌的风险可能较低。这些女性应接受 MHT 治疗直至 50 岁，因为患乳腺癌的风险与正常月经女性相同。在降低风险的双侧输卵管卵巢切除术 (RRSO) 后发生 BRCA 1 和 2 突变的携带者，没有个人癌症病史，患乳腺癌的风险增加，但可能会在 50 岁之前接受 MHT 治疗。子宫内膜异位症导致的 POI或癌症相关治疗将在本期的另一篇论文中讨论。

对于有绝经症状和/或需要 MHT 的骨质疏松症危险因素的围绝经期和绝经后妇女，可以使用基于互联网的计算器评估个体乳腺癌风险。在大多数女性中，5 年乳腺癌风险较低（<3%），MHT 是一种安全的选择。中度风险 (3-6%) 的女性应谨慎开具 MHT，而乳腺癌高风险 (>6%) 的女性不应开具 MHT。与其他联合 MHT 方案相比，仅雌激素 MHT 和含有微粉化黄体酮或地屈孕酮的雌激素 - 孕激素 MHT 与较低的乳腺癌风险相关。