Clinical consideration of two key questions in assessing menopausal status of female breast cancer patients

Jian ZHANG

doi:10.19401/j.cnki.1007-3639.2024.07.001

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Clinical consideration of two key questions in assessing menopausal status of female breast cancer patients

Specialist' Commentary | 更新时间：2025-12-31

- Clinical consideration of two key questions in assessing menopausal status of female breast cancer patients
- China Oncology Vol. 34, Issue 7, Pages: 619-627(2024)
- 作者机构：
  
  复旦大学附属肿瘤医院肿瘤内科，复旦大学附属肿瘤医院Ⅰ期临床试验病房，复旦大学上海医学院肿瘤学系，上海 200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2024.07.001
  CLC： R737.9
- Received：22 May 2024，
  
  Revised：2024-07-03，
  
  Published：30 July 2024
- 稿件说明：
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Jian ZHANG. Clinical consideration of two key questions in assessing menopausal status of female breast cancer patients[J]. China Oncology, 2024, 34(7): 619-627.
DOI：

Jian ZHANG. Clinical consideration of two key questions in assessing menopausal status of female breast cancer patients[J]. China Oncology, 2024, 34(7): 619-627. DOI： 10.19401/j.cnki.1007-3639.2024.07.001.

摘要

内分泌治疗在激素受体阳性乳腺癌中扮演着至关重要的角色，并与患者的绝经状态密切相关。本文旨在深入探讨关于乳腺癌患者绝经状态判断的两个关键问题。第一，针对绝经前患者添加卵巢功能抑制（ovarian function suppression，OFS）治疗后，雌二醇（estradiol，E2）数值仍超标，可能存在“真性”超标和“假性”超标两种情况，氟维司群、阿贝西利、依西美坦及他莫昔芬等内分泌治疗药物可能干扰E2测定结果，需要警惕检测性“假性”超标的可能性。第二，在判断OFS治疗下患者是否已进入生理性绝经状态时，需考虑化疗对绝经状态的影响、围绝经期内分泌变化的复杂性等因素。建议根据患者年龄及内分泌治疗方案，考虑转换治疗并定期监测血清E2和卵泡刺激素（follicle-stimulating hormone，FSH）水平，针对疑难情况可综合抗缪勒管激素（anti-Mullerian hormone，AMH）、抑制素B（inhibin B，INHB）和雄激素等指标进行评估。

Abstract

Endocrine therapy plays a crucial role in hormone receptor-positive breast cancer and is closely related to the patient’s menopausal status. This manuscript aimed to explore two key questions in assessing menopausal status of breast cancer patients. Firstly

for premenopausal patients receiving ovarian function suppression (OFS) therapy

persistently elevated estradiol (E2) levels post-treatment may be attributed to either “true” or “pseudo” elevation

with caution needed due to potential interference from endocrine therapy drugs such as fulvestrant

abemaciclib

exemestane and tamoxifen. Secondly

when determining whether patients under OFS therapy have reached physiological menopause

factors such as the impact of chemotherapy on menopausal status and the complexity of hormone levels around menopause need to be considered. It is recommended to consider switching treatments based on the patient’s age and original endocrine therapy

and to regularly monitor levels of estradiol and follicle-stimulating hormone (FSH). In challenging cases

a comprehensive evaluation can be conducted by incorporating markers such as anti-Mullerian hormone (AMH)

inhibin B (INHB) and androgen.

关键词

Keywords

references

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