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Long-lasting menopause symptoms may be tied to slightly higher breast cancer risk

(Reuters Health) – Women who experience symptoms of menopause, like hot flashes or night sweats, for many years may be slightly more likely to develop breast cancer than women who never had these symptoms, a U.S. study suggests.

But while women with long-lasting menopausal symptoms may have a slightly higher risk for breast cancer, they are not more likely to die from the disease, the study found.

Based on the results, such women should get regular mammograms, but they don’t need to take different precautions than what’s currently recommended for breast cancer screening, lead study author Dr. Rowan Chlebowski told Reuters Health in a phone interview.

“I think the clinical recommendation at this point could just be diligence to continue screening mammography adherence,” said Chlebowski, an oncologist at the City of Hope National Medical Center in Duarte, California.

Presently, the American College of Obstetricians and Gynecologists (ACOG) recommends mammograms every 1-2 years for women who face an average risk of developing breast cancer, starting no later than age 50.

According to ACOG, so called vasomotor symptoms – such as hot flashes and night sweats – are the most commonly reported menopausal symptoms, occurring in up to 82 percent of women after natural menopause. Usually, these symptoms peak about a year after the final menstrual period and are not associated with any extra risk for breast cancer.

In a small proportion of women, however, the symptoms persist for many years. The new study focused on nearly 10,000 women with long-standing menopausal symptoms, half of whom had persistent symptoms for more than a decade. Researchers compared these women to nearly 16,000 women who went through menopause without any such symptoms.

During 18 years of follow-up, 1,399 women developed breast cancer – and the risk was 13 percent higher in the women with persistent vasomotor symptoms than in women who didn’t have these symptoms at all.

Like Chlebowski, other experts interviewed by Reuters Health do not believe extra breast cancer screening is needed for women with persistent menopausal symptoms, beyond what’s currently advised for the average woman.

“The women were over age 50. Recommendations are for mammograms every 1-2 years . . . The findings don’t change this recommendation,” Dr. Monica Christmas, director of the Menopause Program at the University of Chicago, told Reuters Health by email.

“All women over the age of 40 should follow guidelines for breast cancer screening,” she added, whether or not they experience vasomotor symptoms.

Christmas, who was not involved in the study, also noted that about 70 percent of women in the study were Caucasian, “so the results might not apply to everyone.”

Professor Susan Davis, President of the International Menopause Society and Chair of the Women’s Health Research Program at Monash University in Australia, and her colleague in the Women’s Health Research Program, epidemiologist Professor Robin Bell, who were not involved in the study, worry that the findings “will simply frighten people unnecessarily.”

Because the new study excluded women who had vasomotor symptoms for brief periods, its participants “are not at all representative” of the average population of women, they emphasized in an email.

They also pointed out that obesity, alcohol use, breast density and having never been pregnant are all associated with well documented and far more substantial risks of breast cancer. Unlike the duration of menopause symptoms, they noted, “These risk factors are not only important but (in the case of) obesity and alcohol use are modifiable.”

SOURCE: Menopause, online December 28, 2019.

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