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.