Does menopausal status influence the symptom experience of women prior to breast cancer surgery?

Abstract

149 Background: Breast cancer treatments can change women’s hormonal milieu and alter their symptom experience. Little is known about associations between menopausal status and menopausal symptoms in women with breast cancer prior to treatment with surgery, chemotherapy, and/or hormonal therapy. The purpose of this study was to evaluate for differences in menopausal symptom experience between pre- and post-menopausal women prior to breast cancer surgery. Methods: A total of 312 women with breast cancer completed the Menopausal Symptoms Scale, a self-report measure that evaluates the occurrence, severity, and distress of 46 common symptoms associated with menopause. Results: Of the 312 patients enrolled, 37.4% (n=116) were premenopausal and 62.6% (n=196) were postmenopausal. No differences were found in the total number of symptoms reported between premenopausal (x̅ = 13.3±7.8) and postmenopausal (x̅ = 12.0±8.6; t = 1.35, p=.177) patients. Premenopausal patients reported higher occurrence rates for tearful/crying spells, painful/tender breasts, anxiety, lost interest in things, anger, tension, lost sexual interest, fatigue or tiredness, impatience, headache, and nervousness (p<.05 for all). Premenopausal patients reported lower occurrence rates for joint pain/stiffness (p=.011), difficulty falling asleep, vaginal dryness, daytime sweats, and hot flashes (p<.01 for all). A significant interaction was found between age and menopausal status. In the premenopausal group, as age increased, these women were significantly more likely to have hot flashes (p=.033). In the postmenopausal group, as age increased, these women were significantly less likely to have hot flashes, wake during the night, have headaches, and report nervousness (p<.01 for all). In the bivariate and multivariate analyses, none of the symptom severity or distress scores were significantly different between the pre- and post-menopausal patients. Conclusions: Findings from this study suggest that, regardless of menopausal status, women report a high occurrence of menopausal symptoms. The association between menopausal symptom occurrence and menopausal status depends on the specific menopausal symptom and the patient’s age. Clinical trial information: NCT00769821.