Dr Melisha Thambyaiyah1, Dr Natassia Rodrigo1,2,3
1Department of Endocrinology, Royal North Shore Hospital, St Leonards, Australia, 2The Kolling Institute, St Leonards, Australia, 3University of Sydney, Camperdown, Australia
Biography:
Dr Melisha Thambyaiyah is a final year Endocrinology Advanced Trainee undertaking a dedicated Menopause Fellowship at Royal North Shore Hospital, Sydney. She has a particular interest in women's health and the prevention and management of chronic disease. Her current work focuses on delivering individualised, multidisciplinary care for women navigating menopause within specialist settings, including those with complex medical comorbidities.
Aims:
Breast cancer survivors experience greater menopause symptom burden with more limited treatment options. This audit characterised the clinical profile and management patterns of breast cancer survivors attending a dedicated NSLHD menopause hub.
Methods:
Retrospective audit of 39 breast cancer survivors (19.5% of 200 consecutive patients) capturing demographics, oncological history, menopause hormone therapy (MHT) use, allied health referrals and outcomes using the Menopause Specific Quality of Life (MENQOL) questionnaire across vasomotor, psychosocial, physical and sexual domains.
Results:
Mean age was 52.4 years, most were oestrogen receptor (ER) positive (56.4%) with active aromatase-inhibitor (23.1%) or tamoxifen (12.8%) use. Baseline MENQOL scores reflected moderate-to-high symptom burden. In the paired cohort (n=14), post intervention improvement was observed across all domains, most notably vasomotor (mean change −0.64). MHT was used in 35.9%, predominantly vaginal (n=9) or transdermal (n=5) oestrogen. Fezolinetant was the most common non-hormonal agent (33.3%). Mental health comorbidities were present in 25.6% and associated with higher burden across all domains. Allied health referrals were generated for 48.7%.
Conclusion:
Menopause management in breast cancer survivors is complex with high vasomotor and psychosocial burden and significant psychological comorbidity. Multidisciplinary approaches and newer non-hormonal agents show promise although small paired sample sizes limit definitive conclusions.