Menopausal symptoms among breast cancer patients 6 months after diagnosis: a report from the Shanghai Breast Cancer Survival Study

Objective: The aim of this study was to estimate the prevalence of menopausal symptoms in relation to treatment modalities in Asian women treated for breast cancer. Methods: A population-based cohort of 5,023 Chinese women aged 25 to 70 years with primary stage 0 to III breast cancer was identified from a population-based tumor registry and enrolled in the study approximately 6 months after diagnosis. Participants were asked about the occurrence of specific menopausal symptoms. Associations between these symptoms and breast cancer treatments were evaluated by stratified, multivariate logistic regression. Results: Among women with a recent diagnosis of breast cancer, 67.2% of premenopausal women and 46.3% of postmenopausal women experienced at least one menopausal symptom, namely, hot flashes, night sweats, and/or vaginal dryness. Symptom prevalence among postmenopausal women decreased progressively with age at diagnosis (63.3% for women aged 51-55 y, 51.5% for women aged 56-60 y, and 34.4% for women aged >65 y; P < 0.01). Overall, the highest prevalence of most symptoms occurred in women aged 46 to 55 years (P < 0.01). Chemotherapy was positively associated with the occurrence of any symptom and with each individual symptom, mainly in premenopausal women (adjusted odds ratio [OR] range, 2.2-3.3; P < 0.05 for all). Tamoxifen use and immunotherapy were associated with having any symptom and with each individual symptom, regardless of menopause status (adjusted OR range, 1.5-1.8 and 1.3-1.5, respectively; P < 0.05 for all). Women treated before menopause were at particularly high risk of experiencing two or more symptoms after chemotherapy (OR, 1.77; 95% CI, 1.54-4.98; P-interaction = 0.05) compared with postmenopausal women. Conclusions: Menopausal symptoms are prevalent among Chinese women recently treated for primary breast cancer. These symptoms are associated with age and menopause status at the time of diagnosis, as well as with the type of treatment received.