Risk of menopause during the first year after breast cancer diagnosis

Purpose: Premenopausal women with breast cancer often enter a premature men opause during initial treatment of their malignancy with resulting loss of childbearing capacity, onset of menopausal symptoms, and subsequent prolong ed exposure to long-term risks of menopause. Adjuvant therapy is believed t o contribute to this early menopause. Patients and Methods: One hundred eighty-three premenopausal women with loc oregional breast cancer (tumor-node-metastasis staging system classificatio n, T1-3 N0-1 M0) who had undergone surgical treatment and provided informat ion on menopausal status at diagnosis and 1 year later were enrolled. Syste mic adjuvant therapy was recorded. Univariate and multivariate predictors o f menopause were examined. Results: Age, weight gain, tumor stage, nodal stage, and systemic adjuvant therapy (chemotherapy, tamoxifen) were all significant univariate correlate s of menopause. In multivariate analysis, age, chemotherapy, and hormone th erapy (tamoxifen) made significant independent contributions to the onset o f menopause. Conclusion: Age and systemic chemotherapy ore the strongest predictors of m enopause in women with locoregional breast cancer. They independently contr ibute to menopause. A graphic representation of our multivariate model allo ws an estimation of risk of menopause according to patient age and planned adjuvant treatment, and if may facilitate clinical decision-making. (C) 199 9 by American Society of Clinical Oncology.