Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 2 2000
Play
Audio Below:
Menopause
is a physiologic process that probably starts at menarche and continues
throughout a woman’s life. We know even that after menstruation
ceases, there are still variations in the remaining years of a woman’s
life in terms of circulating estrogen levels. And so, menopause
is not a moment in time, it’s a very dynamic process. We know
that some women go to 55 - 60, well, I don’t know how many
60, but certainly 56, 57 years of age and are still menstruating.
In fact, I think it was in the overview that we calculated that
among women 50 to 59, 20% are still premenopausal in that age group.
So that’s why, when we use the cut point of age 50, we’re
actually including a lot of premenopausal women in those analysis.
Now, that’s not to say that the cut point of 50 wasn’t
a rational one, because they recognized that its hard to define
exactly when menopause occurs. And, therefore, they use 50 because
that was a more precise point. But I think it has muddled things
a little bit in terms of our thinking, because there’s no question
in my mind there are interactions with the therapies we use in the
adjuvant setting and the menstrual status of the patient.
Relevant
Articles:
Variation
in the interaction between familial and reproductive factors on
the risk of breast cancer according to age, menopausal status, and
degree of familiality.
Andrieu N. Prevost T. Rohan TE. Luporsi E. Le MG. Gerber M. Zaridze
DG. Lifanova Y. Renaud R. Lee HP. Duffy SW. International Journal
of Epidemiology. 29(2):214-23, 2000.
Bias
in breast cancer analyses due to error in age at menopause.
Rockhill B. Colditz GA. Rosner B. American Journal of Epidemiology.
151(4):404-8, 2000.
