Journal List > Asian Oncol Nurs > v.19(2) > 1129325

Park, Jung, Kim, Bae, and Jo: Menopausal Symptoms and Quality of Life Among Breast Cancer Patients with Chemotherapy-induced Amenorrhea

초록

Purpose

The aim of this study was to evaluate the severity of menopausal symptoms and their impact on the quality of life (QOL) in breast cancer patients with chemotherapy-induced amenorrhea.

Methods

A cross-sectional survey design was used. Participants were 112 breast cancer patients with chemotherapy-induced amenorrhea. They completed the Menopause Rating Scale (MRS) and the Functional Assessment of Cancer Therapy-General (FACT-G). Data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and multiple regression with SPSS/WIN 23.0.

Results

The prevalence of symptoms among the participants were as follows: sleep problems, 88.4%; physical and mental exhaustion, 80.4%; joint and muscular discomfort, 76.8%; and depression, 70.5%. Menopausal symptoms had a significant negative association with QOL. The results of the regression analysis showed that psychological and urogenital symptoms were statistically significant in explaining patients’ QOL and accounted for 70% of the total variance.

Conclusion

Menopausal symptoms appear to be a significant problem for premenopausal breast cancer patients. Assessment and control of menopausal symptoms played a large role in maintaining the quality of life in breast cancer patients.

REFERENCES

1. Jung KW, Won YJ, Kong HJ, Lee ES;. Community of Population-Based Regional Cancer Registries. Community of population-based regional cancer R. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2015. Cancer Res Treat. 2018; 50:303–16.
2. Korean Breast Cancer Society. Breast cancer facts & figures. Seoul: Korean Breast Cancer Society;2018.
3. Baron JM, Boster BL, Barnett CM. Ado-trastuzumab emtansine (T-DM1): a novel antibody-drug conjugate for the treatment of HER2-positive metastatic breast cancer. J Oncol Pharm Pract. 2015; 21:132–42.
crossref
4. Chung S, Park SK, Sung H, Song N, Han W, Noh DY, et al. Association between chronological change of reproductive factors and breast cancer risk defined by hormone receptor status: results from the Seoul Breast Cancer Study. Breast Cancer Res Treat. 2013; 140:557–65.
crossref
5. Manganiello A, Hoga LA, Reberte LM, Miranda CM, Rocha CA. Sex-uality and quality of life of breast cancer patients post mastectomy. Eur J Oncol Nurs. 2011; 15:167–72.
crossref
6. Ruddy KJ, Partridge AH. Fertility (male and female) and menopause. J Clin Oncol. 2012; 30:3705–11.
crossref
7. Rosenberg SM, Partridge AH. Premature menopause in young breast cancer: effects on quality of life and treatment interventions. J Thorac Dis. 2013; 5(Suppl 1):S55–61.
8. Mar Fan HG, Houédé-Tchen N, Chemerynsky I, Yi QL, Xu W, Harvey B, et al. Menopausal symptoms in women undergoing chemotherapy-induced and natural menopause: a prospective controlled study. Ann Oncol. 2010; 21:983–7.
crossref
9. Partridge AH, Burstein HJ, Winer EP. Side effects of chemotherapy and combined chemohormonal therapy in women with early-stage breast cancer. J Natl Cancer Inst Monogr. 2001; 30:135–42.
crossref
10. Gang M, Jung MS, Park S, Park Y, Oh K. How menopause symptoms and attitude Impact Korean women's quality of life after adjuvant treatment for breast cancer. Cancer Nurs. 2017; 40:E60–6.
crossref
11. Benshushan A, Rojansky N, Chaviv M, Arbel-Alon S, Benmeir A, Im-bar T, et al. Climacteric symptoms in women undergoing risk-reducing bilateral salpingo-oophorectomy. Climacteric. 2009; 12:404–9.
crossref
12. Kaur N, Gupta A, Sharma AK, Jain A. Survivorship issues as determinants of quality of life after breast cancer treatment: report from a lim-ited resource setting. Breast. 2018; 41:120–6.
crossref
13. Han JA, Choi SY, Lee S. Effects of menopausal symptoms and depression on the quality of life of premenopausal women with breast cancer in Korea. J Transcult Nurs. 2019; 30:8–16.
crossref
14. Park H, Yoon HG. Menopausal symptoms, sexual function, depression, and quality of life in Korean patients with breast cancer receiving chemotherapy. Support Care Cancer. 2013; 21:2499–507.
crossref
15. Yi M, Hwang E. Pain and menopause symptoms of breast cancer patients with adjuvant hormonal therapy in Korea: secondary analysis. Asia Pac J Oncol Nurs. 2018; 5:262–9.
crossref
16. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993; 11:570–9.
crossref
17. Lee MS, Kim JH, Park MS, Yang J, Ko YH, Ko SD, et al. Factors influencing the severity of menopause symptoms in Korean post-meno-pausal women. J Korean Med Sci. 2010; 25:758–65.
crossref
18. Biglia N, Moggio G, Peano E, Sgandurra P, Ponzone R, Nappi RE, et al. Effects of surgical and adjuvant therapies for breast cancer on sexuality, cognitive functions, and body weight. J Sex Med. 2010; 7:1891–900.
crossref
19. Santen RJ, Stuenkel CA, Davis SR, Pinkerton JV, Gompel A, Lumsden MA. Managing menopausal symptoms and associated clinical issues in breast cancer survivors. J Clin Endocrinol Metab. 2017; 102:3647–61.
crossref
20. Stuenkel CA, Davis SR, Gompel A, Lumsden MA, Murad MH, Pinkerton JV, et al. Treatment of symptoms of the menopause: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2015; 100:3975–4011.
crossref
21. Gupta P, Sturdee DW, Palin SL, Majumder K, Fear R, Marshall T, et al. Menopausal symptoms in women treated for breast cancer: the prevalence and severity of symptoms and their perceived effects on quality of life. Climacteric. 2006; 9:49–58.
crossref
22. Chuni N, Sreeramareddy CT. Frequency of symptoms, determinants of severe symptoms, validity of and cutoff score for menopause rating scale (MRS) as a screening tool: a cross-sectional survey among midlife Nepalese women. BMC Womens Health. 2011; 11:30.
crossref
23. Lee EH, Moon S, Song YS, Chun M. Relationships of lymphedema, the shoulder range of motion, fatigue and social support to the health related quality of life in patients with breast cancer. J Breast Cancer. 2010; 13:212–8.
crossref
24. Moon Z, Moss-Morris R, Hunter MS, Carlisle S, Hughes LD. Barriers and facilitators of adjuvant hormone therapy adherence and persis-tence in women with breast cancer: a systematic review. Patient Prefer Adherence. 2017; 11:305–22.
crossref
25. Park HM. Climacteric symptoms and hormone therapy. J Korean Med Assoc. 2006; 49:11–29.
26. Farthmann J, Hanjalic-Beck A, Veit J, Rautenberg B, Stickeler E, Erbes T, et al. The impact of chemotherapy for breast cancer on sexual function and health-related quality of life. Support Care Cancer. 2016; 24:2603–9.
crossref
27. Marino JL, Saunders CM, Emery LI, Green H, Doherty DA, Hickey M. How does adjuvant chemotherapy affect menopausal symptoms, sexual function, and quality of life after breast cancer? Menopause. 2016; 23:1000–8.
crossref
28. Lee GN, Lee DS. Sexual experiences of women with breast cancer. Asian Oncol Nurs. 2011; 11:210–20.
crossref
29. Gorman JR, Malcarne VL, Roesch SC, Madlensky L, Pierce JP. Depressive symptoms among young breast cancer survivors: the importance of reproductive concerns. Breast Cancer Res Treat. 2010; 123:477–85.
crossref
30. Reyes-Gibby CC, Anderson KO, Morrow PK, Shete S, Hassan S. Depressive symptoms and health-related quality of life in breast cancer survivors. J Womens Health (Larchmt). 2012; 21:311–8.
crossref

Table 1.
Demographic and Clinical Variables of Study Participants (N =112)
Variables Categories n (%) or M ± SD t or F p
Age (years) <45 50 (44.6) 0.83 .691
  ≥45 62 (55.4)    
  range: 29~54 44.1 ± 5.3    
Marital status Single 19 (17.0) 0.78 .510
  Married 93 (83.0)    
Educational level High school graduate or less 50 (44.6) 0.17 .847
  College or higher 62 (55.4)    
Employment Yes 46 (41.1) 0.32 .811
  No 66 (58.9)    
Stage I 27 (24.1) 1.90 .155
  II 68 (60.7)    
  III 17 (15.2)    
Antihormonal therapy Yes 85 (75.9) 0.26 .608
  No 27 (24.1)    
Radiation Yes 92 (82.1) 2.09 .151
  No 20 (17.9)    
Target therapy Yes 23 (20.5) 0.16 .695
  No 89 (79.5)    
Type of surgery Partial mastectomy 88 (78.6) 0.20 .654
  Total mastectomy 24 (21.4)    
Chemotherapy drug AC-T 47 (42.0) 0.34 .850
  AC 35 (31.2)    
  TC 19 (17.0)    
  Other 11 (9.8)    

AC-T= Adriamycin/cyclophosphamide-paclitaxel; AC= Doxorubincin/cyclophosphamide; TC= Docetaxel/cylcophosphamide.

Table 2.
Prevalence of Menopausal Symptoms (N =112)
Symptom Women having symptoms Women with moderate to severe symptoms
% %
Sleep problems 88.4 25.9
Physical and mental exhaustion 80.4 38.4
Joint and muscular discomfort 76.8 54.5
Depressive mood 70.5 35.7
Hot flushes, sweating 68.7 47.3
Irritability 68.7 42.0
Bladder problems 67.0 48.2
Heart discomfort 65.2 43.7
Sexual problems 58.9 36.6
Anxiety 58.0 21.4
Dryness of vagina 55.4 30.4
Table 3.
Correlation between Menopausal Symptoms and Quality of Life (N =112)
Variables M ± SD Somato-vegetative symptoms Psychological symptoms Urogenital symptoms
r (p) r (p) r (p)
Somato-vegetative symptoms 6.64 ± 4.17 -    
Psychological symptoms 5.11 ± 3.70 .68 (<.001) -  
Urogenital symptoms 4.19 ± 2.98 .49 (<.001) .45 (<.001) -
Quality of life 71.04 ± 17.30 -.65 (<.001) -.82 (<.001) -.50 (<.001)
Physical well-being 21.49 ± 6.29 -.68 (<.001) -.80 (<.001) -.80 (<.001)
Social / family well-being 15.75 ± 5.72 -.27 (<.001) -.40 (<.001) -.40 (<.001)
Emotional well-being 16.73 ± 4.53 -.39 (<.001) -.79 (<.001) -.79 (<.001)
Functional well-being 17.06 ± 5.41 -.52 (<.001) -.62 (<.001) -.27 (.004)
Table 4.
Factors Affecting Quality of Life (N =112)
Variables B SE β t p
Somato-vegetative symptoms -0.57 .331 -.13 -1.71 .090
Psychological symptoms -3.15 .337 -.67 -9.35 <.001
Urogenital symptoms -0.80 .353 -.14 -2.26 .026
    R=. 840, R2= .706, Adj. R2= .70, F= 86.43, p<.001  
TOOLS
Similar articles