I have been fascinated by the work of Dr. Zsuzsanna Suba for several years. Not because her ideas are mainstream. They are not.

I kept reading her papers because the more I learned about estrogen, the harder it became for me to believe that its only important job in breast cancer is to make cells grow.

Estrogen matters all over the body. It matters in the brain, bones, blood vessels, muscles, skin, vagina, vulva, bladder, metabolism, and immune system.

It also matters inside our cells.

Every week, I hear some version of the same fear from women who have been treated for breast cancer.

“There could be a cell left in me. If I take estrogen, it will wake up.”

Sometimes it comes up when we talk about testosterone.

“But what if some of it converts to estrogen? Could that wake something up?”

And there it is again. The fear that even a drop of estrogen could bring the cancer back.

Someone she trusts has explained it this way, and that explanation stays with her. Now, even thinking about a hormone that might help her feel better comes with a frightening question: could I be putting myself in danger?

For as long as I have worked in women’s health, I have heard the same script. Estrogen “feeds” breast cancer. The safest thing we can do is block it, hard and for as long as possible. Aromatase inhibitors, tamoxifen, and the other endocrine drugs are framed as our best hope.

A woman finishes five years of endocrine therapy. She did everything that her oncology team told her to do. She took the pill every day. She lived with the hot flashes, the aching joints, the foggy brain, the sleepless nights. She was told this treatment would lower her chance of the cancer returning.

And then, years later, it comes back anyway.

I hear this story more often than most women are ever told to expect. And when it happens, the question we ask is almost always the wrong one. We ask…..