Menopause-related side effects in HR+ early breast cancer: insights from clinical practice

Ovarian function suppression (OFS) and premature menopause lead to side effects that significantly worsen the quality of life for young women with hormone receptor-positive early breast cancer (HR+ eBC).

We retrospectively analyzed the most common side effects of OFS and endocrine therapy (ET) in young women with HR+ eBC.

This analysis was designed as a combined cohort study according to STROBE criteria.

We retrospectively identified 118 patients (pts); after excluding pts with luteinizing hormone-releasing hormone analogs given for fertility preservation only and pts with permanent castration (surgical or by irradiation), 100 pts were included in the final analysis. We analyzed side effects that were represented by more than 10% of patients at any predefined time points. We looked at the frequency and dynamics of these side effects over time-baseline, 6th, 12th, 18th, 24th, 30th, and 36th month according to three categories-the entire population, according to age (younger and older than 40 years), and according to previous treatment (chemotherapy or not).

The most commonly reported side effects among the entire patient group were vasomotor symptoms, particularly hot flashes and night sweats. Sleep disturbances and anxiety were also reported, though less frequently. The most significant worsening of vasomotor symptoms occurred within the first 6 months. Women under 40 years of age reported night sweats and sleep disturbances more often than women aged 40 and older at all time points, with statistically significant differences observed at 30 months for both symptoms and at 12 months for night sweats alone. Among patients who did not receive CT, hot flashes were frequently reported; however, only night sweats showed a statistically significant difference at 6 months compared to the group that did receive CT. No significant differences were found in the frequency of sleep disturbances or anxiety between these groups.

Young women with HR+ eBC undergoing OFS plus ET commonly report side effects in clinical practice. The most frequently reported symptoms are hot flashes, night sweats, sleep disturbances, and anxiety. All symptoms were more pronounced at the 30-month follow-up compared to baseline.