What best predicted menopause after breast cancer diagnosis?

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Premenopausal women with breast cancer often enter premature menopause during initial cancer treatment, losing childbearing capacity, developing menopausal symptoms, and facing prolonged exposure to the long-term risks of menopause. Adjuvant therapy is believed to contribute to this early menopause.

The study enrolled 183 premenopausal women with locoregional breast cancer, classified as T1-3 N0-1 M0 under the tumor-node-metastasis staging system. All had undergone surgery and provided information about their menopausal status at diagnosis and one year later. Researchers recorded systemic adjuvant therapy and examined predictors of menopause using univariate and multivariate analyses.

In univariate analyses, age, weight gain, tumor stage, nodal stage, and systemic adjuvant therapy—chemotherapy and tamoxifen—were all significantly associated with menopause. In the multivariate analysis, age, chemotherapy, and hormone therapy with tamoxifen each made a significant independent contribution to the onset of menopause.

The authors concluded that age and systemic chemotherapy were the strongest predictors of menopause in women with locoregional breast cancer, each contributing independently. A graphical representation of their multivariate model allows menopause risk to be estimated according to patient age and planned adjuvant treatment and may help clinical decision-making.