Brennan Annabelle, Hickey Martha
Royal Women's Hospital, Parkville, Victoria Australia.
Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia.
Semin Reprod Med. 2020 Sep;38(4-05):309-314. doi: 10.1055/s-0041-1726467. Epub 2021 Mar 31.
The global incidence of breast cancer is increasing, as is the efficacy of treatments. Consequently, increasing survival rates reinforce the importance of survivorship issues, including posttreatment menopausal symptoms, sexual function, and mental health and well-being. Breast cancer patients can experience a range of menopausal symptoms associated with their treatment. Most commonly women may experience vasomotor symptoms, including hot flushes and night sweats. Particularly for women on maintenance tamoxifen therapy, up to 80% will experience hot flushes, with almost one-third of these women reporting severe symptoms. Breast cancer patients may also experience genitourinary symptoms of menopause, which may include vaginal dryness and irritation, dyspareunia, and dysuria. Hormonal therapy has long been established as the most effective treatment for vasomotor symptoms. However, the hormonal nature of breast malignancies renders systemic hormone therapies unsuitable for these patients, posing a unique treatment challenge, which may result in clinicians not feeling confident to manage them. Consequently, this review outlines pharmacological and nonpharmacological options for women with bothersome menopausal symptoms after breast cancer treatment and provides practical, evidence-based guidance for clinicians.
全球乳腺癌发病率在上升，治疗效果也在提高。因此，生存率的提高强化了生存问题的重要性，包括治疗后的更年期症状、性功能以及心理健康和幸福感。乳腺癌患者在治疗过程中可能会出现一系列与治疗相关的更年期症状。最常见的是，女性可能会出现血管舒缩症状，包括潮热和盗汗。特别是对于接受他莫昔芬维持治疗的女性，高达80%会出现潮热，其中近三分之一的女性报告有严重症状。乳腺癌患者还可能出现更年期泌尿生殖系统症状，包括阴道干燥和刺激、性交困难和排尿困难。长期以来，激素疗法一直被认为是治疗血管舒缩症状最有效的方法。然而，乳腺恶性肿瘤的激素性质使得全身激素疗法不适用于这些患者，这带来了独特的治疗挑战，可能导致临床医生对管理这些症状缺乏信心。因此，本综述概述了乳腺癌治疗后出现令人困扰的更年期症状的女性的药物和非药物治疗选择，并为临床医生提供实用的、基于证据的指导。
