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25 IMPACT OF AGE AT MENOPAUSE ON BREAST CANCER INCIDENCE
9th European Congress on Menopause and Andropause / Maturitas 71, Supplement 1 (2012) S1–S82
SP1. Calculating Spearman’s CF of Total Score (TS) within the population, excellent correlation (ρ=0.9238) was noted; nonetheless, results were less concordant result among the BC positive cases (ρ=0.7743). Indeed, 20 samples were differentially classified using the antibodies (only 3 had higher TS with 1D5). Considering the mean TS of all samples, or of invasive ductal carcinoma, SP1 provided higher scores than 1D5 (p<0.05). Despite the equivalence between the anti-ERα monoclonal antibodies, SP1 and 1D5, the former has proven superior to the latter with respect to the IS and TS. We suggest the clinical use of SP1 while diagnosing BC, due to its higher accuracy in examining ER status.
22 EVALUATION OF RADIATION CHRONIC CUTANEOUS REACTIONS IN BREAST CARCINOMA PATIENTS F.H. Shandiz 1 , R. Salek 1 , A. Amirabadi 1 , M.J. Yazdanpanah 2 , M.T. Shakeri 3 . 1 Radiation Oncology, Cancer Research Center of MUMS; 2 Dermatology; 3 Estatistic, University of Medical Science, Mashhad, Iran Background: The objective of this study was to assess the chronic cutaneous toxicities in view of their frequency and related factors in patients with breast carcinoma who received radiation of the breast after postmastectomy. Method: In our study, 194 patients with Stage I-II and III breast carcinoma treated with radiation by cobalt-60 machine to the breast bed and regional lymphatic areas were evaluated. The Radiation dose was 50 Gray (Gy) over 5 to 6 weeks. Assessment of skin complications was on RTOG criterias that are widely adopted. Results: Out of 194 women that were assessed, 55 patients (28.4%) with no adverse side effects were classified as RTOG grade 0; 50 (25.8%) were RTOG grade 1, 42 (21.6%) were RTOG grade 2, 16 (8.2%) were RTOG grade 3 and 31 (12.6%) patients were RTOG grade4 chronic skin toxicity. Patient age, Radiation fraction size, history of acute skin complications, Surgery type, time interval between treatment and evaluation and Skin surface dose affect chronic cutaneous compications. Conclusion: The overall cosmetic results of breast radiation therapy in our center was acceptable and the rate of grade 0 to 2 chronic skin complications was high (79.2%). A range of factors are pointed out that affect inapproperiate results.
23 CLINICAL CHARACTERISTICS OF BREAST CANCERS DETECTED ON HORMONE THERAPY IN KOREAN WOMEN J.B. Son 1 , J.K. Joo 1 , S.T. Oh 2 , K.S. Lee 1 . 1 Obstetrics & Gynecology, Pusan National University, Busan; 2 Obstetrics & Gynecology, Chonnam National University, Gwangju, Republic of Korea Objectives: This study was performed to assess the risk factors, histologic, clinical features of breast cancers occurred from postmenopausal women who receiving HT. Methods: We evaluated 40 breast cancer patients who receiving HT. Results: In risk factors of breast cancer patients, only 1 patient had familial history of breast cancer. Average BMI was 23.24 kg/m2 . 12 patients (30%) had estrogen only therapy, 13 patients (32.5%) had combined estrogen and progesterone therapy, 10 patients (25%) had tibolone therapy and the others consecutively received combination therapy of above regimens. Duration of treatment was 31±27.9 (0.4 - 115) months. In distribution of the cancer outbreaking after starting HT, 4 cases (10%) was within 1 year, 5 cases (12.5%) within 1-2 years, 10 cases (25%) within 2-3 years, 4 cases (10%) within 3-4 years, 1 case (2.5%) within 4-5 years, and 16 cases (40%) within more than 5 years. Average diameter of tumor size was 1.7cm. Ductal type of histology consisted of 92.5% of tumor. Tumor stage 0 and I were appeared to 66% and grade I was showed 38% that was most frequent. Hormone receptor-positive breast cancers were 85% and 70% of patients had negative LN metastases, and 5-year survival rate was 92%. Conclusion: Emerged breast cancers during HT in postmenopausal women had hormone receptor-positive tendency. The size and stage of these breast cancers were showed small and low, and represented low-grade differentiation. Recurrences of disease were uncommon and came out favorable 5-year survival rates (92%).
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24 SUPPORT FOR MENOPAUSE SYMPTOMS IN INDIAN WOMEN WITH BREAST CANCER N. Tanna 1,2 , D. Shah 3 , J. Pitkin 1,4 . 1 Womens Services, N W London Hospitals NHS Trust; 2 NIHR CLAHRC London, National Institutes of Health Research, London, UK; 3 Past President, Indian Menopause Society, Mumbai, India; 4 Hon. Senior Lecturer, Imperial College School of Science & Medicine, London, UK Introduction: We report findings from research in Mumbai where women with breast cancer were asked about their cancer journey. They referred to menopausal symptoms suffered and support they had to help manage these symptoms as part of this journey. Method: Facilitated focus group discussion, recorded with patient consent, with thematic analysis of transcription. Results with discussion: 6 women (5 Indian) accepted the invitation from Cancer Patient Aid Association to participate in the session. One English patient, diagnosed in the UK, was living with her partner working in Mumbai. All spoke in English, except when discussing “cooling foods” when the Indian name was mentioned. Two women had asked for help with control of menopausal symptoms. One patient before diagnosis of breast cancer had seen her doctor, was offered HRT, but stopped treatment due to weight gain. She did not associate her later vasomotor symptoms, refractory to breast cancer treatment, as menopause associated symptoms. The English patient had been advised acupuncture. These women highlighted the difficult decision making process when weighing up risks and benefits of Aromatase Inhibitors with side effects causing adverse affect on quality of life versus not using these treatments with better day to day quality of life. They identified need for counseling and menopause related information for all women going through the menopause. Conclusion: Our work has identified a need for support for Indian women going through the menopause, with breast cancer patients needing this provided in a timely fashion to help with improved quality of life.
25 IMPACT OF AGE AT MENOPAUSE ON BREAST CANCER INCIDENCE A. Tsigginou, C. Dimitrakakis, S. Marinopoulos, A. Giannos, S. Detorakis, A. Antsaklis. Breast Unit, 1st Dept. of Ob/Gyn, Athens University Medical School, Alexandra Hospital, Athínai, Greece Aim: Breast cancer occurs mainly in post-menopausal women. Menopause age represent a significant reproductive risk factor. Late menopause is considered to increase breast cancer risk while early menopause, spontaneous or surgical, is considered protective. The purpose of this study was to retrospectively examine the impact of age at menopause in a population of breast cancer patients. Methods: 367 postmenopausal women diagnosed with breast cancer were divided in 3 groups: women with menopause at an average age (46 to 55 years old), women with late menopause (older than 55 years) and women with early menopause (younger than 45 years). Results: 69% of the patients were included in the first group with menopause at an average age, 10% presented with late menopause, while 21% had an early menopause. Between the three groups, mean age of breast cancer diagnosis was similar (64, 66 and 65 years old, respectively). The mean time between menopause and breast cancer diagnosis was 10.4 years for the group of late menopause, 13.4 years for the average menopause group and was significantly greater in the early menopause group (23.2 years). Also, on diagnosis, 70% of women of each of the 3 groups were staged I to II. Conclusions: In our population, early menopause does not demonstrate a protective effect on breast cancer incidence. Age and not age at menopause emerges as a more important risk factor in disease incidence.
SP1. Calculating Spearman’s CF of Total Score (TS) within the population, excellent correlation (ρ=0.9238) was noted; nonetheless, results were less concordant result among the BC positive cases (ρ=0.7743). Indeed, 20 samples were differentially classified using the antibodies (only 3 had higher TS with 1D5). Considering the mean TS of all samples, or of invasive ductal carcinoma, SP1 provided higher scores than 1D5 (p<0.05). Despite the equivalence between the anti-ERα monoclonal antibodies, SP1 and 1D5, the former has proven superior to the latter with respect to the IS and TS. We suggest the clinical use of SP1 while diagnosing BC, due to its higher accuracy in examining ER status.
22 EVALUATION OF RADIATION CHRONIC CUTANEOUS REACTIONS IN BREAST CARCINOMA PATIENTS F.H. Shandiz 1 , R. Salek 1 , A. Amirabadi 1 , M.J. Yazdanpanah 2 , M.T. Shakeri 3 . 1 Radiation Oncology, Cancer Research Center of MUMS; 2 Dermatology; 3 Estatistic, University of Medical Science, Mashhad, Iran Background: The objective of this study was to assess the chronic cutaneous toxicities in view of their frequency and related factors in patients with breast carcinoma who received radiation of the breast after postmastectomy. Method: In our study, 194 patients with Stage I-II and III breast carcinoma treated with radiation by cobalt-60 machine to the breast bed and regional lymphatic areas were evaluated. The Radiation dose was 50 Gray (Gy) over 5 to 6 weeks. Assessment of skin complications was on RTOG criterias that are widely adopted. Results: Out of 194 women that were assessed, 55 patients (28.4%) with no adverse side effects were classified as RTOG grade 0; 50 (25.8%) were RTOG grade 1, 42 (21.6%) were RTOG grade 2, 16 (8.2%) were RTOG grade 3 and 31 (12.6%) patients were RTOG grade4 chronic skin toxicity. Patient age, Radiation fraction size, history of acute skin complications, Surgery type, time interval between treatment and evaluation and Skin surface dose affect chronic cutaneous compications. Conclusion: The overall cosmetic results of breast radiation therapy in our center was acceptable and the rate of grade 0 to 2 chronic skin complications was high (79.2%). A range of factors are pointed out that affect inapproperiate results.
23 CLINICAL CHARACTERISTICS OF BREAST CANCERS DETECTED ON HORMONE THERAPY IN KOREAN WOMEN J.B. Son 1 , J.K. Joo 1 , S.T. Oh 2 , K.S. Lee 1 . 1 Obstetrics & Gynecology, Pusan National University, Busan; 2 Obstetrics & Gynecology, Chonnam National University, Gwangju, Republic of Korea Objectives: This study was performed to assess the risk factors, histologic, clinical features of breast cancers occurred from postmenopausal women who receiving HT. Methods: We evaluated 40 breast cancer patients who receiving HT. Results: In risk factors of breast cancer patients, only 1 patient had familial history of breast cancer. Average BMI was 23.24 kg/m2 . 12 patients (30%) had estrogen only therapy, 13 patients (32.5%) had combined estrogen and progesterone therapy, 10 patients (25%) had tibolone therapy and the others consecutively received combination therapy of above regimens. Duration of treatment was 31±27.9 (0.4 - 115) months. In distribution of the cancer outbreaking after starting HT, 4 cases (10%) was within 1 year, 5 cases (12.5%) within 1-2 years, 10 cases (25%) within 2-3 years, 4 cases (10%) within 3-4 years, 1 case (2.5%) within 4-5 years, and 16 cases (40%) within more than 5 years. Average diameter of tumor size was 1.7cm. Ductal type of histology consisted of 92.5% of tumor. Tumor stage 0 and I were appeared to 66% and grade I was showed 38% that was most frequent. Hormone receptor-positive breast cancers were 85% and 70% of patients had negative LN metastases, and 5-year survival rate was 92%. Conclusion: Emerged breast cancers during HT in postmenopausal women had hormone receptor-positive tendency. The size and stage of these breast cancers were showed small and low, and represented low-grade differentiation. Recurrences of disease were uncommon and came out favorable 5-year survival rates (92%).
S33
24 SUPPORT FOR MENOPAUSE SYMPTOMS IN INDIAN WOMEN WITH BREAST CANCER N. Tanna 1,2 , D. Shah 3 , J. Pitkin 1,4 . 1 Womens Services, N W London Hospitals NHS Trust; 2 NIHR CLAHRC London, National Institutes of Health Research, London, UK; 3 Past President, Indian Menopause Society, Mumbai, India; 4 Hon. Senior Lecturer, Imperial College School of Science & Medicine, London, UK Introduction: We report findings from research in Mumbai where women with breast cancer were asked about their cancer journey. They referred to menopausal symptoms suffered and support they had to help manage these symptoms as part of this journey. Method: Facilitated focus group discussion, recorded with patient consent, with thematic analysis of transcription. Results with discussion: 6 women (5 Indian) accepted the invitation from Cancer Patient Aid Association to participate in the session. One English patient, diagnosed in the UK, was living with her partner working in Mumbai. All spoke in English, except when discussing “cooling foods” when the Indian name was mentioned. Two women had asked for help with control of menopausal symptoms. One patient before diagnosis of breast cancer had seen her doctor, was offered HRT, but stopped treatment due to weight gain. She did not associate her later vasomotor symptoms, refractory to breast cancer treatment, as menopause associated symptoms. The English patient had been advised acupuncture. These women highlighted the difficult decision making process when weighing up risks and benefits of Aromatase Inhibitors with side effects causing adverse affect on quality of life versus not using these treatments with better day to day quality of life. They identified need for counseling and menopause related information for all women going through the menopause. Conclusion: Our work has identified a need for support for Indian women going through the menopause, with breast cancer patients needing this provided in a timely fashion to help with improved quality of life.
25 IMPACT OF AGE AT MENOPAUSE ON BREAST CANCER INCIDENCE A. Tsigginou, C. Dimitrakakis, S. Marinopoulos, A. Giannos, S. Detorakis, A. Antsaklis. Breast Unit, 1st Dept. of Ob/Gyn, Athens University Medical School, Alexandra Hospital, Athínai, Greece Aim: Breast cancer occurs mainly in post-menopausal women. Menopause age represent a significant reproductive risk factor. Late menopause is considered to increase breast cancer risk while early menopause, spontaneous or surgical, is considered protective. The purpose of this study was to retrospectively examine the impact of age at menopause in a population of breast cancer patients. Methods: 367 postmenopausal women diagnosed with breast cancer were divided in 3 groups: women with menopause at an average age (46 to 55 years old), women with late menopause (older than 55 years) and women with early menopause (younger than 45 years). Results: 69% of the patients were included in the first group with menopause at an average age, 10% presented with late menopause, while 21% had an early menopause. Between the three groups, mean age of breast cancer diagnosis was similar (64, 66 and 65 years old, respectively). The mean time between menopause and breast cancer diagnosis was 10.4 years for the group of late menopause, 13.4 years for the average menopause group and was significantly greater in the early menopause group (23.2 years). Also, on diagnosis, 70% of women of each of the 3 groups were staged I to II. Conclusions: In our population, early menopause does not demonstrate a protective effect on breast cancer incidence. Age and not age at menopause emerges as a more important risk factor in disease incidence.