Counseling women at elevated breast cancer risk about menopausal hormone therapy is one of the most clinically nuanced conversations in women's health — and most providers lack a structured framework for doing it well. In this session, Dr. Sabrina Sahni draws on her dual subspecialty training in women's health and medical breast medicine to deliver a practical, evidence-based approach to MHT counseling in this population. She will review how to stratify breast cancer risk, interpret the evidence on MHT safety across risk categories — including women with benign breast disease, dense breasts, BRCA carriers, and those with a personal history — and how to translate that evidence into individualized, shared decision-making conversations that are both clinically sound and patient-centered—a session designed to move providers from avoidance to confidence.

Sabrina Sahni, MD, MSCP, is a board-certified family medicine physician and Menopause Society Certified Practitioner with dual fellowship training in Specialized Women's Health and Medical Breast — both completed at the Cleveland Clinic. Her clinical practice focuses on the intersection of menopause management and breast health, with particular expertise in hormone therapy counseling for women at elevated breast cancer risk, breast cancer risk assessment, benign breast disease, and survivorship care. Dr. Sahni has authored peer-reviewed publications on hormone therapy in women with benign breast disease, menopausal hormone therapy in older women, and non-hormonal management of vasomotor symptoms, and is an active member of The Menopause Society, the International Society for the Study of Women's Sexual Health, and the National Consortium of Breast Centers. Her rare combination of menopause and breast medicine subspecialty training positions her as a uniquely qualified voice on one of clinical women's health's most consequential — and most frequently mishandled — counseling challenges.