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Menopausal symptoms in breast cancer survivors nearly 6 years after diagnosis

Davis, Susan R. MB, BS, PhD, FRACP; Panjari, Mary PhD; Robinson, Penelope J. MBiostat; Fradkin, Pamela MBBS; Bell, Robin J. MB, BS, PhD, MPH, FAFPHM

doi: 10.1097/GME.0000000000000219
Original Articles

Objective: We investigated the prevalence and severity of menopausal symptoms, nearly 6 years from diagnosis, in women who had not experienced recurrent breast cancer or a new primary breast cancer (active disease) and were no longer taking oral adjuvant endocrine therapy (OAET).

Methods: A total of 1,683 women recruited within 12 months of diagnosis with invasive breast cancer completed an enrollment questionnaire and five annual follow-up questionnaires. Only women who had never reported active disease and were not taking OAET at their fifth follow-up were included in the analysis. Women previously recruited to a study of sex steroid levels provided community control data. Menopausal symptoms were assessed with the Menopause-Specific Quality of Life Questionnaire (MenQOL).

Results: Eight hundred forty-three women without active disease and not taking OAET completed the fifth follow-up questionnaire, on average, 5.8 years after diagnosis. Most had stage I (59.5%) and hormone receptor–positive disease (77.9%) at diagnosis and were postmenopausal (92.8%). Those aged 50 to 59 years were more likely to report any symptoms (P = 0.01) and more severe symptoms (P < 0.001) than older and younger women. There was no independent impact of chemotherapy on MenQOL vasomotor and sexual domain scores. Women with breast cancer had significantly higher vasomotor domain (P ≤ 0.002) and sexual domain (P ≤ 0.004) scores than community controls.

Conclusions: Vasomotor and sexual symptoms are highly prevalent in breast cancer survivors and are not simply a function of OAET or chemotherapy. Given the adverse impact of these symptoms, effective interventions are needed to alleviate them in women who have completed their breast cancer treatment.

From the Women’s Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Received October 29, 2013; revised and accepted January 15, 2014.

None of the named funding bodies had any role in the design of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. Roy Morgan Research formatted and scanned the study questionnaires.

Funding/support: This work was supported by the BUPA Health Foundation, the National Health and Medical Research Council of Australia (grant 219279), Novartis Oncology Australia, the L.E.W. Carty Trust, the Jack and Robert Smorgon Families Foundation, the Connie and Craig Kimberley Victorian Cancer Agency (P.J.R. and R.J.B.), and Roy Morgan Research. M.P. is a National Health and Medical Research Council of Australia postdoctoral fellow (grant 1034977). S.R.D. is a National Health and Medical Research Council of Australia principal research fellow (grant 1041853).

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Susan R. Davis, MB, BS, PhD, FRACP, Women’s Health Program, School of Public Health and Preventive Medicine, Monash University, Level 6, 99 Commercial Road, Melbourne 3004, Australia. E-mail:

© 2014 by The North American Menopause Society.