Role of Menopause in Breast Cancer

Introduction

Breast cancer has a higher incidence rate and is the second most common cancer to be diagnosed globally. As per the International Agency for Cancer report, the mortality rate of breast carcinoma in women is 12.5 million globally. Various risk factors affect the nature of disease presentation and the characteristics of the tumor. Usually, the risk factors are divided into two types, modifiable risk factors, and unmodifiable risk factors.

Modifiable risk factors consist of lifestyle choices that can be modified. Unmodifiable risk factors include genetics, age, family history, and menstrual period. The risk of breast cancer rises more as women ages. The menstruation period in women affects the risk of breast cancer in women. The long duration of estrogen exposure increases the risk. The incidence of breast cancer is more in postmenopausal women as compared to premenopausal women. Drugs used to treat menopausal symptoms also increase the risk of breast cancer.

What Is Menopause?

Menopause is the time duration of the life of a woman during which the menstrual cycle ends. It usually occurs during the 4th to 5th decade of life. However, it is a natural biological process in every woman's life.

Following are the signs and symptoms of menopause in women:

• Irregular period onset during the menstrual phase.

• Vaginal dryness.

• Night sweats.

• Increase in body weight and metabolism disorder.

• Hot flashes and chills.

• Behavioral and emotional changes, including irritation, mood swings, and moderate depression.

• Loss of libido.

• Hair loss.

What Is Breast Cancer?

A breast tumor known as breast cancer is caused by the uncontrolled and uncontrollable growth of breast cells. Their tumor cells invade the surrounding breast region. It can spread to other parts of the body through metastasis. It is one of the most commonly found tumors in women.

Following are the various types of breast cancer:

• Ductal Carcinoma - In this type of carcinoma, the tumor breaks through the ductal region and spreads to the other parts.

• Lobular Carcinoma - This type of carcinoma breaks through the lobules and spreads to other areas of the body.

• Carcinoma In Situ - In this condition, abnormal cells are found in the lobular region of the breast.

• Triple Negative - In this carcinoma markers are not associated with the onset.

Risk factors for breast cancer include non-modifiable factors such as age, gender, family history, and genetics, as well as modifiable factors such as hormone replacement therapy, alcohol consumption, physical inactivity, poor diet, obesity, and exposure to ionizing radiation.

Depending on the stage and features of the cancer, there are a variety of treatment available for breast cancer, which includes surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, or a combination of these methods.

What Is the Role of Menopause in Breast Cancer?

• Hormonal Changes: The risk of breast carcinoma increases after the onset of the menstrual phase in a woman's life. There is increased exposure to estrogen hormones, and the number of ovulations increases women's risk of uterine breast and ovarian cancer. On the other hand, breast cancer treatments such as hormone therapy and chemotherapy cause menopause symptoms in women. It acts as ovarian suppression, which can temporarily or permanently cause menopausal symptoms in women.

• Age: The average age of menopause in women is around 51, and it normally happens between the ages of 45 and 55. Women are more likely to get breast cancer as they get older. Therefore, the age at which menopause occurs can impact a woman's chances of having breast cancer. Menstruation at an early age, before the second decade of life, and having a child at an early age also increases a woman's risk of breast cancer. The risk factors of breast cancer increases with a longer duration of hormone exposure.

• Hormone Replacement Therapy (HRT): Some women may undergo hormone replacement therapy (HRT) during or after menopause to manage symptoms. Breast cancer risk has been linked to long-term HRT use, especially in women who take an estrogen and progesterone combination for an extended period of time.

• Breast Density: Breast cancer risk may be dependent on breast density, which is the quantity glandular tissue and connective tissue in the breast. Breast density can be influenced by menopause, and women with higher breast densities may be at an increased risk of breast cancer. As women age and go through menopause, their breast density tends to decrease, which may impact their breast cancer risk.

What Is Menopausal Hormone Therapy?

Hormone replacement therapy (HRT), also known as Menopausal hormone therapy (MHT) or hormone therapy (HT), is a medical treatment that involves taking estrogen and/or progesterone hormones to relieve or manage the symptoms of menopause. Menopausal hormone therapy is primarily used to alleviate menopausal symptoms like night sweats, vaginal dryness, hot flashes, sleep disturbances, and mood swings. It can also be used to prevent osteoporosis (bone loss) that reduces the risk of fractures in postmenopausal women.

There are two types of hormone therapy: combined hormone therapy and estrogen hormone therapy. In combined hormonal therapy, progesterone is given as estrogen increases carcinoma risk. In estrogen replacement therapy, estrogen hormone is given, increasing the risks of breast cancer in women.

Menopausal hormone therapy can be administered in various forms, including pills, patches, creams, gels, and vaginal preparations. The choice of the type, route, and duration of hormone therapy depends on individual factors such as a woman's age, symptoms, medical history, and personal preferences.

It is important to note that menopausal hormone therapy is not apt for everyone, and there are potential risks and benefits to consider. Hormone therapy has been linked to higher risks of breast cancer, heart disease, stroke, blood clots, and gallbladder disease.

The choice to utilize menopausal hormone treatment should be decided in conjunction by a healthcare professional, taking into account the individual’s overall health and medical history as well as any potential benefits and hazards.

Conclusion

Breast cancer is the biggest health challenges in the current times because of its increasing rate of incidence. The onset and cessation of menarche and menopause affect the incidence rate of breast cancer. Estrogen ovarian hormones increase the women's reproductive years and the risk of ductal tumors. Menarche and menopause are the markers of ovarian and endocrine activity in a woman's body.Hormonal medication used after menopause also increases the risk of breast cancer. Early detection is important for the successful treatment of breast cancer. Regular clinical breast exams, breast self-exams, and mammograms are important screening methods for detecting breast cancer early when it is most treatable. The menopausal symptoms can be managed in healthy and safe ways such as regular exercise, stress reduction, proper sleep, and avoiding alcohol consumption and smoking.