173: Breast Cancer, Estrogen & HRT: What Women Need to Know with Dr. Liz O'Riordan

Can you use HRT after breast cancer? Is vaginal estrogen safe for breast cancer survivors? Are mammograms dangerous? And is ultrasound a better option?

In this episode of Confessions of a Male Gynecologist, Dr. Shawn Tassone sits down with Dr. Liz O'Riordan, former breast surgeon, breast cancer patient, author, and advocate, for a candid conversation about breast cancer, estrogen, hormone therapy, screening, survivorship, and the realities of becoming the patient after years of being the doctor.

Dr. O'Riordan thought she understood breast cancer. Then she was diagnosed herself.

Her experience revealed a side of cancer care that medical training often doesn't teach: the fear of diagnosis, the physical and emotional effects of treatment, the impact of medically induced menopause, sexual health concerns, and the difficult decisions patients face when balancing recurrence risk with quality of life.

Dr. Tassone and Dr. O'Riordan explore one of the most controversial conversations in women's health today: estrogen and hormone replacement therapy after breast cancer.

Together, they discuss why conversations about estrogen and breast cancer are often far more complicated than "estrogen causes cancer" or "HRT is safe," how age, tumor biology, treatment history, individual risk, symptoms, and personal priorities can all influence the conversation, and why informed consent matters when women are making decisions about their health.

They also discuss the important distinction between systemic hormone therapy and local vaginal estrogen, particularly for breast cancer survivors struggling with vaginal dryness, painful sex, urinary symptoms, and other consequences of estrogen deprivation.

The conversation expands beyond hormones into another growing problem: breast cancer misinformation online.

Do mammograms cause breast cancer? Can you replace a mammogram with an ultrasound? Can a biopsy cause cancer to spread?

Dr. O'Riordan addresses common fears surrounding breast cancer screening and explains why misinformation can become dangerous when it prevents women from receiving appropriate evaluation or screening. They also discuss the concerning rise of breast cancer diagnoses among younger women, what women should understand about risk and screening, and why breast health cannot be reduced to a single test or universal recommendation.

Finally, they examine something that often receives far too little attention during cancer treatment: quality of life.

Exercise, nutrition, sexual health, menopause symptoms, mental health, relationships, patient support, and personal autonomy all matter during survivorship. Treating cancer is important, but so is treating the woman living through it.

This is a conversation about what breast cancer care looks like from both sides of the exam room and what medicine could do better when physicians truly understand the patient experience.

In This Episode, You'll Learn:

• Can women take HRT after breast cancer?
• Estrogen and estrogen-receptor-positive breast cancer
• Why "estrogen causes breast cancer" is an oversimplification
• Systemic HRT versus vaginal estrogen after breast cancer
• Menopause symptoms caused by breast cancer treatment
• Vaginal dryness, painful sex, and sexual health after cancer
• Quality of life versus recurrence-risk conversations
• What doctors may misunderstand about the patient experience
• Dr. Liz O'Riordan's transition from breast surgeon to breast cancer patient
• Rising breast cancer diagnoses among younger women
• Mammograms versus breast ultrasounds
• Whether mammogram radiation causes breast cancer
• Misinformation surrounding breast biopsies
• Exercise and breast cancer survivorship
• Nutrition and lifestyle after breast cancer
• Mental health and isolation during cancer treatment
• Patient autonomy and informed consent
• How breast cancer care could better support the whole patient

About Dr. Liz O'Riordan

Dr Liz O'Riordan blends surgical precision with human insight to deliver powerful messages, communication that holds, and resilience through change. A consultant breast surgeon who has faced cancer three times, Liz brings a rare dual perspective on what it means to lead, support others, and stay composed in a world of constant change, burnout risk, and fragile workplace cultures. Drawing on surgical training and her own experience of losing and regaining control, she gives repeatable methods to help people stay calm under pressure, communicate clearly when it counts, and adapt to disruption without falling apart.

Liz speaks globally about how to improve the quality of patient care. Her experience as a cancer surgeon and patient, combined with the voice of over 200k people in her community, enables her to show healthcare professionals what patients really need when they leave the clinic.

Alongside her keynotes, Liz delivers interactive workshops where teams practise the core habits behind sustained high performance: structured communication, adaptive leadership, decision-making under pressure, and the ability to stay calm and connected when everything around them is shifting. Her sessions are known for being honest, human, and transformative, not motivational peaks, but lasting changes in how people think and behave when the pressure is real.

Dr Liz is also the best-selling author of four books, including The Cancer Roadmap. She hosts her own podcast and dedicates her spare time to creating educational content for her 200k online community. She was awarded an honorary doctorate in 2025 for her contribution to public education and received the Humanitarian of the Year Award from Future Dreams in 2024 for her advocacy, communication, and leadership. Liz is also a regular voice in international broadcast and print media, known for explaining complex ideas with clarity, warmth, and candour.

Connect with Dr. Liz O'Reardon:

Follow Dr. Liz O'Reardon on Instagram | Instagram
Subscribe to Dr. Liz O'Reardon on YouTube | YouTube Channel
Complete Guide to Breast Cancer by Liz O'Reardon
The Cancer Roadmap by Liz O'Reardon

Episode Resources:

Work with Dr. Tassone | Tassone Advanced Gynecology

Please contact the clinic directly at (512) 956- 0296 with all scheduling inquiries.

Purchase Dr. Tassone's Best-Selling Book | The Hormone Balance Bible

Dr. Tassone's Integrative Hormonal Archetype Quiz | Discover Your Hormonal Archetype

Medical Disclaimer
This podcast and website represent the opinions of Dr. Shawn Tassone and his guests. The content here should not be taken as medical advice and is for informational purposes only. Because each person is so unique, please consult your health care professional for any medical questions.