title: Menopausal state in breast cancer: how reliable is the data?
abstract: Despite the high importance of the menopausal state for the management of breast cancer, above all, when planning antihormonal adjuvant therapy, the menopausal state cannot be defined at the time of diagnosis ina significant proportion of women. The scope of uncertainties regarding the recording of the menopausal state in a cohort of patients with breast cancer is evaluated.
  
  
  BACKGROUND
  Menopause is a cornerstone both in breast cancer (BC) pathophysiology and in clinical management. The scope of uncertainties regarding the recording of the menopausal state in a cohort of patients with BC is evaluated in this study.
  
  
  METHODS
  The data of a Swiss prospective relational BC database that covered a 20-year period (1990-2009; n=1457) was analyzed. For the definition of menopause, the guidelines of the National Comprehensive Cancer Network were used.
  
  
  RESULTS
  The menopausal state was unclear in 150 patients (10.2%). Of these, 122 (81.3%) had undergone a hysterectomy before menopause; in 28 women (18.7%), an endocrine therapy obscured the patient's actual endocrine status. When taking only the subgroup of women in which menopause usually occurs (45-55 years) into consideration, the menopausal state was unclear in 91 cases of 337 women (27.0%). From the entire cohort, the date of last menstruation remained obscure in 450 patients (30.9%).
  
  
  CONCLUSIONS
  Despite the high importance of the menopausal state for the management of BC, above all, when planning antihormonal adjuvant therapy, the menopausal state was unable to be defined at the time of BC diagnosis in a significant proportion of women. The dilemma that menopause cannot be assessed in some BC cases is increasingly being recognized. Close cooperation between oncologists and endocrinologists is desirable to establish an optimal, individually tailored therapy for women with an unclear menopausal state due to hormonal therapies, hysterectomy, or chemotherapy.
authors: Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland.
authors: Rebecca Elizabeth
authors: RE
authors: Moffat
authors: Monika
authors: M
authors: Eichholzer
authors: Mary Elizabeth
authors: ME
authors: Myrick
authors: Seraina Margaretha
authors: SM
authors: Schmid
authors: Anna
authors: A
authors: Raggi
authors: Christian
authors: C
authors: de Geyter
authors: Andreas
authors: A
authors: Schötzau
authors: Uwe
authors: U
authors: Güth
mesh_terms: D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D015203:Reproducibility of Results; D013557:Switzerland
chemical_list: D018931:Antineoplastic Agents, Hormonal