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Journal of Clinical Oncology, Vol 17, Issue 8 (August), 1999: 2365
© 1999 American Society for Clinical Oncology

Risk of Menopause During the First Year After Breast Cancer Diagnosis

Pamela J. Goodwin, Marguerite Ennis, Kathleen I. Pritchard, Maureen Trudeau, Nicky Hood

From the Departments of Medicine and Clinical Epidemiology, Samuel Lunenfeld Research Institute, Mount Sinai Hospital; Department of Medicine, Toronto-Sunnybrook Regional Cancer Centre; Department of Medicine, Women's College Hospital; and Department of Public Health Science, University of Toronto, Toronto, Ontario, Canada.

Address reprint requests to Pamela J. Goodwin, MD, Marvelle Koffler Breast Centre, Mount Sinai Hospital, 1284-600 University Ave, Toronto, Ontario M5G 1X5, Canada; email pgoodwin{at}mtsinai.on.ca

PURPOSE: Premenopausal women with breast cancer often enter a premature menopause during initial treatment of their malignancy, with resulting loss of childbearing capacity, onset of menopausal symptoms, and subsequent prolonged exposure to long-term risks of menopause. Adjuvant therapy is believed to contribute to this early menopause.

PATIENTS AND METHODS: One hundred eighty-three premenopausal women with locoregional breast cancer (tumor-node-metastasis staging system classification, T1-3 N0-1 M0) who had undergone surgical treatment and provided information on menopausal status at diagnosis and 1 year later were enrolled. Systemic adjuvant therapy was recorded. Univariate and multivariate predictors of menopause were examined.

RESULTS: Age, weight gain, tumor stage, nodal stage, and systemic adjuvant therapy (chemotherapy, tamoxifen) were all significant univariate correlates of menopause. In multivariate analysis, age, chemotherapy, and hormone therapy (tamoxifen) made significant independent contributions to the onset of menopause.

CONCLUSION: Age and systemic chemotherapy are the strongest predictors of menopause in women with locoregional breast cancer. They independently contribute to menopause. A graphic representation of our multivariate model allows an estimation of risk of menopause according to patient age and planned adjuvant treatment, and it may facilitate clinical decision-making.




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