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postmenopause

Postmenopausal women with breast cancer

Posted on February 25, 2023

There are a variety of subtypes of breast cancer. Around 70% of them are susceptible to oestrogen, the female sex hormone. These cancers contain receptor sites that bind to oestrogen, which stimulates their development and dissemination. If this is the case, hormone (or endocrine) therapy may be used as a remedy. Postmenopause, the ovaries generate the feminine hormones oestrogen and progesterone. Following menopause, oestrogen is produced in body fat, such as breast fat.

Hormone treatment reduces the quantity of oestrogen in the body or prevents it from attaching to breast cancer cells. It may be used to inhibit oestrogen synthesis in the ovaries (before to menopause), to prevent oestrogen production in fat cells (after menopause), or to prevent oestrogen from interacting with cancer cells. It may minimise the likelihood of breast cancer recurring or spreading.

Breast cancer is uncommon in women under the age of 25, although the chance of having the disease rises with age. Breast Cancer Pills are used to treat breast cancer. It is prescribed to treat early breast cancer in women who have experienced menopause.

Breast cancer in women after postmenopause

The incidence of breast cancer is highest in postmenopausal women, and the majority of breast cancers in this population are hormone receptor positive. The breast fat cells of ageing women tend to generate increasing levels of aromatase. Aromatase stimulates oestrogen production. Hence, oestrogen levels in the breasts of women grow with age. In postmenopausal women, this oestrogen has a role in both the development and progression of breast cancer.

Once established, the tumour works to enhance oestrogen levels in order to promote its growth, with immune cells seeming to encourage oestrogen synthesis. Current research has also shown a connection between obesity and oestrogen production. These results are supported by data showing that obesity doubles the chance of getting breast cancer in older women. This makes sense given that obese women have a greater number of fat cells that produce oestrogens.

Cancer of the breast and hormone (endocrine) treatment

There are a variety of hormone therapy available. They may be used before or after breast surgery, after chemotherapy or radiation treatment, in lieu of surgery (for instance, if surgery is not feasible owing to other health issues) or if breast cancer has spread or returned.

Surgical suppression of ovulation

Ovarian suppression may be an effective therapy for women of childbearing age with ER-positive breast tumours. Ovarian suppression medicines inhibit the production of oestrogen by the ovaries. Only women who have not yet reached menopause may use them.

Ovarian suppression may involve:

Surgical removal of the ovaries (ablation), which decreases oestrogen production permanently, or administration of a gonadotropin-releasing hormone, which decreases oestrogen production temporarily.

Therapy with anti-oestrogen hormones

Anti-oestrogen drugs are used to inhibit the synthesis or activity of oestrogen. Tamoxifen is the most regularly used anti-oestrogen drug. It is often administered after surgery to reduce the chance of breast cancer recurring or spreading to the other breast. While anti-oestrogen hormone therapy may have a variety of adverse effects, the benefits greatly exceed the dangers for the vast majority of women.

Possible adverse effects of tamoxifen include:

Hot flushes disrupt sleep.
Vaginal dryness, vaginal discharge, poor mood, weight gain, irregular periods, hair loss, diminished libido, skin changes, and exhaustion.
Tamoxifen is effective for treating women of all ages.

Aromatase inhibiting treatment

Arimidex 1mg inhibitors are drugs that prevent oestrogen from being produced in adipose tissue (AIs). Examples include letrozole, anastrozole and exemestane. AIs block aromatase from generating oestrogens, hence decreasing breast oestrogen levels.

Unlike tamoxifen, AIs have been demonstrated to offer higher advantages and less major adverse effects. Medication that causes the breakdown of the oestrogen receptor, such as fulvestrant, is used in contemporary therapy.

Among the potential adverse effects of aromatase inhibitors are:

a fever, joint stiffness, and osteoporosis.
Aromatase inhibitors are exclusively prescribed to women who have passed menopause.

Current research focuses on chemicals targeted to inhibit oestrogen synthesis in the breast alone, while the body still requires oestrogen for bone health and other functions.

Cancer of the breast and hormone replacement treatment

The menopause may cause uncomfortable side effects such as hot flashes and vaginal dryness. Hormone replacement treatment (HRT) alleviates symptoms by increasing levels of sex hormones. Moreover, it minimises the risk of osteoporosis and cardiovascular disease.

As certain breast cancers are oestrogen-dependent, women who use HRT for more than five years are at a 0.3-fold greater risk. Women who take HRT for shorter durations (such as two years) have the same breast cancer risk as those who have never used HRT. In many instances, the health advantages of HRT for women in early postmenopause may exceed the dangers.

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