Menopause after breast cancer: a survey on breast cancer survivors

Biglia, Nicoletta; Cozzarella, M; Cacciari, F.; Ponzone, Riccardo; Roagna, Riccardo; Maggiorotto, Furio; Sismondi, P

doi:10.1016/s0378-5122(03)00087-2

Cited by 118 publications

(90 citation statements)

References 40 publications

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“…As previously documented in cross-sectional surveys, 4,16,17 we observed that premenopausal women had a greater increase in tamoxifeninduced hot flashes compared with peri-or postmenopausal women. Prior history of chemotherapy may alter the risk of tamoxifen-induced hot-flashes in premenopausal women.…”

Section: Discussionsupporting

confidence: 84%

Estrogen Receptor Genotypes Influence Hot Flash Prevalence and Composite Score Before and After Tamoxifen Therapy

Jin

Hayes

et al. 2008

JCO

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A B S T R A C T PurposeHot flashes are common and frequently lead to drug discontinuation among women prescribed tamoxifen. We determined whether genetic polymorphisms in estrogen receptors (ESRs) ␣ and ␤ (ESR1 and ESR2, respectively) are associated with tamoxifen-induced hot flashes. Patients and MethodsWe determined ESR1 PvuII and XbaI and ESR2-02 genotypes in 297 women who were initiating tamoxifen. One-week hot flash diaries were collected to calculate a hot flash score (frequency ϫ severity) before and 1, 4, 8, and 12 months after starting tamoxifen. ResultsApproximately 80% of 297 participants reported hot flashes before or during the first year of tamoxifen. After 4 months of tamoxifen, premenopausal women who did not receive adjuvant chemotherapy had a four-fold increase in hot flash score (from 5.9 to 23.6; P ϭ .003) compared with a 1.17-fold increase (from 19.6 to 23; P ϭ .34) in those who received chemotherapy. In premenopausal women, increased number of ESR1 PvuII and XbaI CG alleles was associated with higher baseline hot flash scores compared with those who had other haplotypes (P ϭ .0026). At 4 months, postmenopausal women with ESR1 PvuII CC and ESR2-02 GG genotypes had 4.6 times increases in hot flash scores than other postmenopausal women (56 v 12; P ϭ .0007). Women who had the ESR2-02 AA genotype were significantly less likely to experience tamoxifen-induced hot flashes than women who carried at least one ESR-02 G allele (hazard ratio, 0.26; 95% CI, 0.10 to 0.63; P ϭ .001). ConclusionKnowledge of menopausal status, prior chemotherapy, and ESR genotype may help predict which women are most likely to suffer hot flashes during tamoxifen treatment.

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Section: Discussionsupporting

confidence: 84%

Estrogen Receptor Genotypes Influence Hot Flash Prevalence and Composite Score Before and After Tamoxifen Therapy

Jin

Hayes

et al. 2008

JCO

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“…Nine of the studies included in this review did not determine eligibility based on age; however, they reported on age-related differences in a sample of breast cancer survivors [5,13,[37][38][39][40][41][42].…”

Section: Resultsmentioning

confidence: 99%

“…The percentage of women who had discussed fertility-related issues with their clinicians varied across studies. Biglia et al [40] found that more than 50% of concerned younger women had consulted with a physician about fertility. Most consulted gynaecologists (61%); oncologists (16%) and/or general practitioners (23%) were consulted less frequently [40].…”

Section: Fertility-related Information Needsmentioning

confidence: 99%

The fertility-related concerns, needs and preferences of younger women with breast cancer: a systematic review

Peate

Meiser

Hickey

et al. 2009

Breast Cancer Res Treat

195

177

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Breast cancer is the most commonly diagnosed type of cancer in reproductive aged women. Adjuvant systemic therapy is recommended in most women and has been demonstrated to reduce the risk of recurrence and increase survival. However, there may be a negative impact of adjuvant systemic therapy on fertility as well as on subsequent quality of life. There are a number of fertility preservation options currently available and relevant information regarding these options should be provided prior to commencing adjuvant treatment. The aim of the review is to identify the fertility-related needs, concerns and preferences of young women with early breast cancer. The databases MEDLINE and EMBASE were searched from 1988 onwards using keywords, and examining reference lists. Of the 499 articles identified, 20 met eligibility criteria and were reviewed. Multiple fertility-related information needs specific to this group regarding menstrual changes and potential infertility attitudes to, and actual decisions made regarding, pregnancy breastfeeding and contraception emerged. Information on fertility-related decisions was rated as important, and the preferred methods for obtaining this information was consultation with a specialist or a decision aid early in the treatment plan. There is limited research about fertility-related needs, and even less on contraceptive preferences and the attitudes of health care providers towards fertility-related issues. No studies describing the development of tools to assist with decisions about fertility-related choices were identified. Young women with early breast cancer have specific fertility- and menopause-related needs and concerns, which are commonly not adequately addressed or discussed prior to commencing adjuvant therapy.

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“…Many patients treated for breast carcinoma complain of severe menopausal symptoms, such as hot flushes, night sweats, genital dystrophy and difficulties in sexual intercourse, accentuated by tamoxifen use or by ovarian inhibition [9] . Breast carcinoma is considered to be an absolute contra-indication for oestrogen therapy, because of the concern that it can activate or accelerate occult micrometastasis or favour secondary tumour growth [10] .…”

Section: Breast Cancermentioning

confidence: 99%

Hormonal Replacement Therapy after Gynaecological Cancer

Biglia

Mariani

Marenco

et al. 2006

Gynäkol Geburtshilfliche Rundsch

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Thousands of women are treated each year for gynaecological cancers; many of these are already in menopause, while other younger patients will go into early menopause due to surgery, chemotherapy and/or radiotherapy to the pelvic region. The aim of this paper is to review the biological and clinical evidence in favour and against hormone replacement therapy (HRT) use after gynaecological cancers. With the exception of breast and endometrial cancer, there is no biological evidence that HRT may increase the recurrence risk. In women with previous endometrial cancer, HRT use is not supported by univocal and conclusive data to formulate specific recommendations, whereas most authors suggest that oestrogens may be used after adequate information about risks and benefits. The use of HRT in breast cancer patients is, at present, considered contra-indicated, even if results of clinical trials are not concordant. Therapeutic non-hormonal alternatives may be proposed to these patients.

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Menopause after breast cancer: a survey on breast cancer survivors

Cited by 118 publications

References 40 publications

Estrogen Receptor Genotypes Influence Hot Flash Prevalence and Composite Score Before and After Tamoxifen Therapy

Estrogen Receptor Genotypes Influence Hot Flash Prevalence and Composite Score Before and After Tamoxifen Therapy

The fertility-related concerns, needs and preferences of younger women with breast cancer: a systematic review

Hormonal Replacement Therapy after Gynaecological Cancer

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