Breast Cancer and Menopause

What You Need to Know About Breast Cancer and Menopause

Menopause marks the end of the menstrual cycle, typically occurring between ages 45 and 55. It’s defined by 12 consecutive months without a period and is preceded by perimenopause, a phase of fluctuating hormones and symptoms including hot flashes, mood swings, sleep disturbances, vaginal dryness, and weight gain. These changes stem from a decline in estrogen and progesterone, two hormones that play key roles in reproductive and breast tissue health.

Menopause and Breast Cancer Risk Level

Age is one of the most significant risk factors for breast cancer. According to the American Cancer Society, most breast cancers are diagnosed in women over 50, which coincides with the average postmenopausal stage. It’s important to note that menopause itself does not have a direct link to developing breast cancer, but because menopause affects hormone levels, it may factor into your risk level:

• Later menopause increases breast cancer risk due to prolonged estrogen exposure.
• Earlier menopause may slightly lower risk but can bring abrupt and intense symptoms—especially if triggered by treatments like chemotherapy or surgery.

Understanding this link helps women assess risk based on their personal and family history.
Regular screening with a mammogram is the best tool physicians have for detecting breast cancer as early as possible. For women with an average risk of developing breast cancer, screening recommendations are:

• Age 40-74: Start screening with mammogram annually.
• Age 75 and over: Should continue with mammograms as long as their overall health is good, and they have a life expectancy of 10 or more years.

Some women with a higher risk level may be recommended to start screening earlier or have additional screening. Talk to your healthcare provider about the screening options best for you.

Hormone Replacement Therapy and the Link to Breast Cancer

Hormone replacement therapy (HRT) is a hormonal treatment that is often prescribed to alleviate menopausal symptoms, like hot flashes, night sweats, and vaginal dryness. Because this medication directly affects hormone levels, there are several factors to consider when it comes to breast cancer risk.

Studies have shown:

• Breast cancer risk level may increase with long-term use (more than five years) of combined HRT (estrogen plus progestin). Individuals between the ages of 50-59 have a lower risk level than patients over 60.
• Estrogen-only HRT may lower the risk of breast cancer in women with prior hysterectomies in all age groups.
• HRT can increase risk of recurrence for anyone who has a history of breast cancer and is not recommended.
• Younger patients with no history of breast cancer may experience significant improvements in quality of life with HRT.

Talk to your physician about your risk level and your options to make an informed decision that best fits your health needs.

Menopause and Breast Cancer Treatment

Breast cancer treatments can significantly affect hormonal balance, often triggering menopause earlier than expected or intensifying its symptoms. This treatment-induced menopause can be temporary or permanent, depending on the type and duration of therapy.

Chemotherapy

Chemotherapy targets rapidly dividing cells, including those in the ovaries. This can lead to:

• Temporary menopause, where menstruation stops during treatment but may resume months or years later.
• Permanent menopause, especially in women nearing natural menopausal age.

Hormone Therapy

Many breast cancers are hormone receptor-positive, meaning they grow in response to estrogen or progesterone. To reduce recurrence risk, hormone therapies are used to block or suppress these hormones:

• Tamoxifen: Blocks estrogen receptors in breast tissue; often used in premenopausal women.
• Aromatase inhibitors (e.g., anastrozole, letrozole): Prevent estrogen production; typically prescribed to postmenopausal women.
• Ovarian suppression: Medications or surgery to stop the ovaries from producing estrogen.

Surgical Menopause

In some patients with a high risk of breast cancer recurrence, the ovaries may be surgically removed. This causes immediate, permanent menopause.

Managing Menopause Symptoms During Breast Cancer Treatment

Symptoms like hot flashes, mood swings, and fatigue may appear suddenly and feel more intense in treatment-induced menopause than in natural menopause due to the abrupt hormonal drop. Some patients may also experience feelings of anxiety or depression.

There are several ways to manage menopausal symptoms:

• Low-dose antidepressants may help manage hot flashes and mood swings.
• Lifestyle modifications, like exercise, adequate sleep, and reduced caffeine and alcohol intake can help with the intensity of menopause symptoms.
• Keeping a diary of your symptoms can help you anticipate them and better prepare yourself to cope.

Talk to your physician if you have any concerns about your menopausal symptoms during chemotherapy.

September 2025