Leining M G, Gelber S, Rosenberg R, Przypyszny M, Winer E P, Partridge A H
Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA, USA.
Ann Oncol. 2006 Dec;17(12):1777-82. doi: 10.1093/annonc/mdl299. Epub 2006 Sep 13.
There has been little previous information available about menopausal-type symptoms in very young breast cancer survivors.
In collaboration with the Young Survival Coalition, we conducted an Internet-based survey of women with a history of breast cancer diagnosed at age 40 years or younger using items derived from the Breast Cancer Prevention Trial symptom checklist.
A total of 371 respondents were eligible for analysis. Mean age at diagnosis was 32.8 years and mean age at follow-up 36.2 years; 89% of women received chemotherapy, 49% tamoxifen, 15% ovarian suppression, 4% aromatase inhibitors. At the time of survey, 37% were taking tamoxifen and 9% ovarian suppression. Excluding women on ovarian suppression, 77% of women were premenopausal at follow-up. Many women reported bothersome menopausal-type symptoms. In particular, 46% of women reported hot flashes and 39% reported dyspareunia. In a linear regression model of symptom scores, current ovarian suppression, postmenopausal status, baseline anxiety before the diagnosis, pregnancy after the diagnosis, prior chemotherapy, and lower perceived financial status were associated with more bothersome symptoms.
A substantial number of young breast cancer survivors experience bothersome menopausal symptoms. While the women who responded to our survey may represent a select group of survivors, these findings may have important implications for treatment decision making and long-term quality of life of young women with breast cancer.
此前关于非常年轻的乳腺癌幸存者绝经类型症状的信息很少。
我们与青年生存联盟合作,对40岁及以下被诊断为乳腺癌的女性进行了一项基于互联网的调查,使用了源自乳腺癌预防试验症状清单的条目。
共有371名受访者符合分析条件。诊断时的平均年龄为32.8岁,随访时的平均年龄为36.2岁;89%的女性接受了化疗,49%接受了他莫昔芬治疗,15%接受了卵巢抑制,4%接受了芳香化酶抑制剂治疗。在调查时,37%的女性正在服用他莫昔芬,9%正在接受卵巢抑制。排除接受卵巢抑制的女性后,77%的女性在随访时处于绝经前状态。许多女性报告了令人烦恼的绝经类型症状。特别是,46%的女性报告有潮热,39%的女性报告有性交困难。在症状评分的线性回归模型中,当前的卵巢抑制、绝经后状态、诊断前的基线焦虑、诊断后的怀孕、先前的化疗以及较低的感知财务状况与更令人烦恼的症状相关。
相当数量的年轻乳腺癌幸存者经历令人烦恼的绝经症状。虽然参与我们调查的女性可能代表了一群特定的幸存者,但这些发现可能对年轻乳腺癌女性的治疗决策和长期生活质量具有重要意义。