The menopause specialist and breast cancer survivorship

Due to improvement in survival rates, breast cancer is the most prevalent female malignancy in Europe and hence the management of breast cancer survivorship is garnering significant attention. Most of the health issues associated with treatment result from iatrogenic estrogen deficiency and recognition of this in the recent National Institute for Health and Care Excellence (NICE) menopause guidance has resulted in the recommendation for referral of breast cancer patients to menopause specialists for appropriate counselling about and management of early menopause, estrogen deficiency symptoms and lifestyle risk modification. The latter has significant implications for both all-cause and breast cancer-specific mortality. Extending the role of health professionals with an interest in menopause to provide such service for breast cancer patients is necessary as this is not within the remit or expertise of specialist breast cancer teams; however it will in turn, require menopause specialists to expand and regularly update their knowledge of breast cancer and its treatment.