School of Women's and Infants' Health, King Edward Memorial Hospital, The University of Western Australia, Crawley, WA, Australia.
Menopause. 2010 Jul;17(4):727-33. doi: 10.1097/gme.0b013e3181d672f6.
The aim of this study was to describe a unique model of multidisciplinary care for women with menopausal symptoms after breast cancer and present preliminary data for 653 women.
The nature and severity of menopausal symptoms in women with breast cancer were measured using a standardized scale.
A total of 578 women with breast cancer were managed at the Menopausal Symptoms After Cancer Clinic between January 2003 and December 2008. The most common reasons for these women to seek treatment were hot flushes (41%), night sweats (36%), loss of interest in sex (30%), difficulty sleeping (25%), and fatigue (22%). Extreme vaginal dryness was also reported in 19% of these women. Chemotherapy-induced ovarian failure was reported by 29% of the breast cancer patients seen. A range of management approaches were offered, with 55% of the women prescribed nonhormonal pharmacological therapies for vasomotor symptoms, including vitamin E 400 IU twice daily (21%), venlafaxine 75 mg CR once daily (13%), clonidine 50 microg twice daily (11%), or gabapentin 300 mg three times daily (4%).
Vasomotor symptoms, sexual dysfunction, and sleep disturbance are the most distressing menopausal symptoms requiring management after breast cancer. Menopausal symptom management after breast cancer may be complex, and we present a novel model of care using a multidisciplinary approach. Additional benefits of this multidisciplinary approach include education opportunities, improved communication and networking opportunities, and decision making in line with evidence-based guidelines.
本研究旨在描述一种针对乳腺癌后绝经期女性的多学科综合护理的独特模式，并呈现 653 例女性的初步数据。
使用标准化量表测量乳腺癌女性的绝经期症状的性质和严重程度。
2003 年 1 月至 2008 年 12 月，共有 578 例乳腺癌女性在癌症后绝经期症状门诊就诊。这些女性寻求治疗的最常见原因是热潮红（41%）、盗汗（36%）、性欲减退（30%）、睡眠困难（25%）和疲劳（22%）。这些女性中也有 19%报告出现极度阴道干燥。29%的乳腺癌患者报告化疗引起的卵巢功能衰竭。提供了一系列管理方法，55%的女性开处非激素药物治疗血管舒缩症状，包括每日两次 400IU 维生素 E（21%）、每日一次 75mg 文拉法辛 CR（13%）、每日两次 50μg 可乐定（11%）或每日三次 300mg 加巴喷丁（4%）。
乳腺癌后最需要管理的绝经期症状是血管舒缩症状、性功能障碍和睡眠障碍。乳腺癌后绝经期症状的管理可能很复杂，我们提出了一种使用多学科方法的新型护理模式。这种多学科方法的额外益处包括教育机会、改善沟通和网络机会以及符合循证指南的决策。
