Breast · Oct 21, 2026

Longitudinal trajectories of menopausal symptoms in women receiving endocrine therapy for breast cancer compared with natural menopause

By Lee SK, Choi HR, Kang D et al.

BACKGROUND: Endocrine therapy (ETx) for hormone receptor-positive breast cancer frequently induces menopausal symptoms that may compromise treatment adherence. However, longitudinal symptom trajectories compared with natural menopause remain unclear. METHODS: This longitudinal study included 5734 women from two prospective cohorts: 2583 women with breast cancer from the Breast Cancer Information Grand Round for Survivorship cohort and 3151 women without breast cancer from the Kangbuk Samsung Health Study. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS). Linear mixed-effects models evaluated longitudinal changes by breast cancer status, menopausal status, and ETx use. Difference-in-differences (DiD) analyses designated premenopausal women without breast cancer as the reference group. RESULTS: Among premenopausal women, ETx was associated with greater increases in total MRS scores than in women without breast cancer (DiD, 3.30; 95% CI, 2.04-4.58 at 1 year). Within the breast cancer cohort, premenopausal women receiving ETx experienced sustained increases in menopausal symptoms over 3 years, with the largest increases observed among those receiving regimens including gonadotropin-releasing hormone agonists. Among postmenopausal women, ETx was associated with modest changes in total MRS scores but a significant increase in urogenital symptoms (DiD 0.71; 95% CI, 0.26-1.16). CONCLUSIONS: Compared with women without breast cancer, women receiving ETx experienced greater increases in menopausal symptoms during the first year of follow-up. Within the breast cancer cohort, elevated symptom burden persisted over 3 years, particularly among premenopausal women receiving ovarian function suppression. These findings highlight the importance of proactive symptom monitoring and supportive care during long-term endocrine therapy.

doi.org/10.1016/j.breast.2026.104947 Open access PubMed 42962501 Interventions