A practical guide to the management of menopausal symptoms in breast cancer patients

Abstract

Breast cancer is the most frequently diagnosed cancer in Canadian women. As a result of increased screening and improved treatment, more women are becoming long-term breast cancer survivors. However, due to either their treatment or prolonged survival, many of these women now have to face the consequences of premature menopause and prolonged estrogen deprivation. Hormone replacement therapy/estrogen replacement therapy (HRT/ERT) has, in the past, been recommended to healthy women at menopause not only for relief of short-term menopausal changes, particularly hot flashes, but also for its benefits on bone density, fracture reduction, and genitourinary symptoms. Recent studies have demonstrated that not only is HRT associated with an increased risk of developing breast cancer, but it also has been shown to increase the risk of recurrence in those with a breast cancer history. Until the safety of HRT/ERT in breast cancer patients can be more fully clarified, it would be wise to develop alternative strategies for the management of menopausal symptoms in these patients. This paper will discuss nonestrogen-based therapies for hot flashes, osteoporosis, and genitourinary symptoms, with emphasis on efficacy and safety in breast cancer survivors.

A survey among breast cancer survivors: treatment of the climacteric after breast cancer

“…Physicians and patients have often tried alternative medications such as phytoestrogens, black cohosh, inhibitors of serotonin reuptake, clonidine, veralipride, gabapentine or tibolone for symptomatic relief 21,22 , even if the efficacy of some of these molecules is not proven and hardly studied at all in breast cancer patients 17,[23][24][25][26] . Since breast cancer affects an increasing number of women, the search for an effective and safe strategy to alleviate their climacteric symptoms has become essential.…”

A Scientometric Analysis of 20 Years of Research on Breast Reconstruction Surgery: A Guide for Research Design and Journal Selection

“…The first mastectomy was performed in 1889 by William Halsted to surgically control breast cancer [ 5 ]. With more appraisal of the necessity of mastectomy for breast cancer patients, the field of breast reconstruction evolved.…”

Early-stage breast cancer menopausal symptom experience and management: exploring medical oncology clinic visit conversations through qualitative analysis

“…Although we did not quantify this phenomenon in our study, these ndings are consistent with a pattern we saw of patients reporting menopausal symptoms, and clinicians not offering any intervention. Data show there are alternative options to HRT, like acupuncture, cognitive behavioral therapy, exercise, limiting alcohol, and nonhormonal medications, that are effective in managing menopausal symptoms in this vulnerable population [7]. Healthcare providers treating women living with breast cancer should be aware of alternative symptom management techniques and resources in their clinical setting.…”