Menopausal vasomotor symptoms and incident breast cancer risk in the Study of Women's Health Across the Nation.

Abstract

Two case-control studies reported a 50% decreased breast cancer risk among women who experienced menopausal vasomotor symptoms (VMS), but one cohort study found no association. VMS may be triggered by declining estrogen levels during menopause, whereas elevated estrogen levels have been associated with increased breast cancer risk. VMS may thus be indicative of lower susceptibility to breast cancer. We evaluated this relationship in the longitudinal Study of Women's Health Across the Nation (SWAN), using discrete survival analysis of approximately annual data on VMS and self-reported breast cancer occurrences for up to 13years of follow-up in 3,098 women who were pre- or early perimenopausal at enrollment. Over an average 11.4years of follow-up, 129 incident breast cancer cases were self-reported, and approximately 50% of participants experienced VMS. Symptomatic women had a reduced risk of breast cancer compared to non-symptomatic women (adjusted HR 0.63, 95% CI 0.39, 1.00). The association was stronger in the subgroup of women who fully transitioned to postmenopause during follow-up (n=67 cases, adjusted HR 0.45, 95% CI 0.26, 0.77). VMS appeared to be a marker of reduced breast cancer risk. Future research is needed to understand the biology underlying this relationship.