Vincent A J
a Menopause Unit, Monash Medical Centre, Monash Health and Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University , Clayton , Victoria , Australia.
Climacteric. 2015 Oct;18(5):690-701. doi: 10.3109/13697137.2014.996749. Epub 2015 Feb 24.
Increasing breast cancer incidence and decreasing mortality have highlighted the importance of survivorship issues related to breast cancer. A consideration of the issues related to menopause is therefore of great importance to both women and clinicians. Menopause/menopausal symptoms, with significant negative effects on quality of life and potential long-term health impacts, may in women with breast cancer be associated with: (1) natural menopause occurring concurrently with a breast cancer diagnosis; (2) recurrence of menopausal symptoms following cessation of hormone replacement therapy; (3) treatment-induced menopause (chemotherapy, ovarian ablation/suppression) and adjuvant endocrine therapy. A variety of non-hormonal pharmacological and non-pharmacological therapies have been investigated as therapeutic options for menopausal symptoms with mixed results, and ongoing research is required. This review presents a summary of the causes, common problematic symptoms of menopause (vasomotor, genitourinary and sexual dysfunction), and longer-term consequences (cardiovascular disease and osteoporosis) related to menopause. It proposes an evidenced-based multidisciplinary approach to the management of menopause/menopausal symptoms in women with breast cancer.
乳腺癌发病率的上升和死亡率的下降凸显了与乳腺癌相关的生存问题的重要性。因此，考虑与更年期相关的问题对女性和临床医生都至关重要。更年期/更年期症状对生活质量有显著负面影响，并可能产生潜在的长期健康影响，在乳腺癌女性中可能与以下情况相关：（1）在乳腺癌诊断时同时出现自然绝经；（2）激素替代疗法停止后更年期症状复发；（3）治疗引起的更年期（化疗、卵巢切除/抑制）和辅助内分泌治疗。已经研究了多种非激素药物和非药物疗法作为更年期症状的治疗选择，但结果不一，仍需进行持续研究。本综述总结了更年期的原因、常见的问题症状（血管舒缩、泌尿生殖和性功能障碍）以及与更年期相关的长期后果（心血管疾病和骨质疏松症）。它提出了一种基于证据的多学科方法来管理乳腺癌女性的更年期/更年期症状。
