Clinical Analysis and Prognostic Significance of Menopausal Status in Breast Cancer

Kim, Gyu Hun; Kim, Lee Su; Lee, Bong Hwa

Abstract

The influence of age and menopausal status at diagnosis on the prognosis of patients with primary breast cancer remains controversial. Some studies have found that younger patients have worse clinical outcomes than older patients, others have reported that younger patients have a more favorable outcome, and others have found no relation with age. We analyzed the effects of menopausal status in the survival of patients with operable breast cancer and estimated the correlations between the menopausal status and other established prognostic factors. We reviewed the records of the patients who had been operated on at the Department of Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University during the past 10 years (1985~1996). The results were as follows: 1) The peak age group was the fifth decade (27%), and all of patients, except one, were females. 2) The most common symptom was a palpable breast mass with or without pain (88%). 3) Most patients (72.8%) visited within 6 months of the first appearance of a symptom, and the most frequent tumor size was 2~5 cm in diameter (58.9%). 4) Most of the primary tumors were located in the upper outer quadrant (61%); tumors located in the lower outer quadrant were rare (3%). 5) The most common TNM stage group was stage II (54.1%), and there was no difference of distribution between the premenopause and the postmenopause groups. 6) The common pathologic cancer types were infiltrating ductal cancer (73.8%), medullary cancer (9.3%), mucinous cancer (8.3%). 7) Axillary lymph-node metastasis was present in 58 cases (62.4%). 8) The overall five-year survival rate for all patients was 43.9%. 9) The five-year survival rates of the 38 premenopausal patients and the 38 postmenopausal patients were 42.4% and 35.8%, respectively, but there was no statically significant difference between the two groups. 10) Menopausal status did not significantly correlated with tumor size, tumor location, lymph-node metastasis or TNM stage. In conclusion, the menopausal status may be not correlated with the prognosis in breast cancer However, the effect of menopausal status on the prognosis of patients with breast cancer needs to be investigated for a large papulation of breast cancer patients.