There is no direct causative link between bio-identical estrogen, progesterone, and breast cancer. The Women's Health Initiative (WHI) study in 2003 raised concerns about "hormones and breast cancer," but a long-term follow-up study published in JAMA in 2017 by one of the original WHI authors found no increased mortality from breast cancer in the subjects over an 18- year period. The number of patients receiving HRT 5 to 10 years after breast cancer treatment and remission is increasing. However, hormone use in patients with a history of hormone-receptor-positive tumors is not yet considered standard care. The decision to use hormones in this situation is an informed one that the patient must make for herself. Finally, patients with or recently recovered from breast cancer can receive testosterone alone to help manage both AIS and menopausal symptoms.