Association of breast cancer and its therapy with menopause-related symptoms.
OBJECTIVE
To study the relationship between current menopause status, occurrence of menopause transition during cancer treatment, and prevalence and severity of possible menopause-related symptoms.


METHODS
Data from the Cancer and Menopause Study (CAMS), a tumor-registry-based cohort of breast cancer survivors (BCS) diagnosed before age 50, were used. Using a standardized symptom checklist, women reported whether they were not at all, slightly, moderately, quite, or extremely bothered in the past 4 weeks by hot flashes, night sweats, vaginal dryness, pain with intercourse, breast sensitivity, joint pains, frequent mood changes, restless sleep, weight gain, forgetfulness, and difficulty concentrating. Current menopause status (by standard categories based on menstruation) and whether a persistent menopause transition occurred during cancer treatment were the main exposures. Linear (symptom severity as continuous outcome) and logistic (symptom present vs absent) regression models were adjusted for age, ethnicity, current smoking, alcohol use, chemotherapy, tamoxifen, body mass index, and depression scores.


RESULTS
Mean age of the participants was 50 years. The prevalence of symptoms was high. Hot flashes occurred in 17%, 51%, and 71% of pre-, peri-, and postmenopausal BCS, respectively. Hot flashes, vaginal dryness, and pain with intercourse were more severe in postmenopausal compared with perimenopausal BCS. Having had a transition during breast cancer treatment was associated with worse hot flash severity, independent of current menopause status.


CONCLUSIONS
Menopause-related symptoms are common in BCS. Effective treatment options are needed. Having a treatment-related transition confers a persistent effect on hot flash severity. Clinicians should include this information when counseling women on potential outcomes of their cancer therapy.
Crandall
Carolyn
C
Division of General Internal Medicine, Jonsson Comprehensive Cancer Center, University of California at Los Angeles, 90095-7023, USA. ccrandall@mednet.ucla.edu
Petersen
Laura
L
Ganz
Patricia A
PA
Greendale
Gail A
GA
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008408:Mastectomy / Q000379:methods; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D047648:Perimenopause / Q000502:physiology; D017697:Premenopause / Q000502:physiology; D015995:Prevalence; D011336:Probability; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires