Magazine article Clinical Psychiatry News

Earlier Menopause: For the Young, Breast Ca Presents Unique Issues

Magazine article Clinical Psychiatry News

Earlier Menopause: For the Young, Breast Ca Presents Unique Issues

Article excerpt

PHILADELPHIA -- Young breast cancer survivors have issues and needs that are unique to their age and not found in older women, presenters said at a meeting sponsored by Living Beyond Breast Cancer and the Young Survival Coalition.

The uniqueness of breast cancer in premenopausal women begins with its diagnosis, said Dr. Kathy Miller, an oncologist in the department of medicine at Indiana University, Indianapolis.

Premenopausal women typically have longer delays in diagnosis than their menopausal and postmenopausal counterparts. "I can't tell you the number of women in their twenties whom I have seen who had a palpable lump in a breast for months or even up to a year," she said. As a consequence of delayed diagnoses, breast cancers in young women tend to be more advanced at diagnosis.

In general, there are no differences by disease stage in the way younger women are treated versus older women. However, there are marked differences in the consequences of treatment.

Young women with breast cancer get to menopause faster and earlier than they otherwise would due to chemotherapy or tamoxifen treatment. "The onset of menopause can occur within several months to a couple of years in a young woman on these therapies," she said.

Determining if a woman is truly post-menopausal is "often difficult," Dr. Miller said. "In women who have treatment-induced amenorrhea, hormonal levels in blood testing can tell you where they are now but not where they will be in 3, 6, or 9 months."

Because breast cancer chemotherapy often causes premature ovarian failure and infertility, young breast cancer patients who want to become pregnant "should not waste time," said Dr. Kutluk Oktay of the Center for Reproductive Medicine and Infertility at Cornell University, New York.

"Chemotherapy may not induce menopause immediately, but menopause might very well occur within 2 or 3 years after chemotherapy," he noted. …

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