TY - JOUR
T1 - Differences in clinician understanding and management of early menopause after breast cancer
AU - Sayakhot, Padaphet
AU - Teede, Helena Jane
AU - Gibson-Helm, Melanie
AU - Vincent, Amanda Jane
PY - 2013
Y1 - 2013
N2 - Objective Investigation of clinicians ? understanding of early menopause diagnosis/management in women
with breast cancer.
Methods A cross-sectional study of 176 randomly recruited Australian clinicians (35 gynecologists, 35
endocrinologists, 36 oncologists, 35 breast surgeons and 35 general practitioners (GPs)) involved in the care
of women with breast cancer. This questionnaire study utilized an index case to assess understanding of early
menopause diagnosis and management. Analysis involved descriptive statistics, ? 2 tests and Student ? s t -test.
Results Signifi cant differences between clinician groups regarding diagnostic criteria for early menopause
were observed; gynecologists, endocrinologists and GPs selected amenorrhea 12 months , whereas oncologists
and breast surgeons selected elevated serum follicle stimulating hormone level ( p 0.05). Non-hormonal
treatment was preferred by most clinician groups. Complementary/alternative medicines were more commonly
prescribed by breast surgeons (57 ), gynecologists (54 ) and endocrinologists (49 ) compared to oncologists
(28 ) or GPs (9 ) ( p 0.0001). Exercise (63 ) and nutrition (66 ) were selected by most gynecologists
for treatment of hot fl ushes, whereas endocrinologists (91 ), oncologists (94 ), breast surgeons (69 )
and GPs (63 ) prescribed venlafaxine. Hormone therapy was mainly prescribed by breast surgeons (43 )
compared to other groups ( p 0.001). Most clinicians reported that the main problem with menopausal
therapies was failure to resolve hot fl ushes. Exercise, lifestyle and stress management were recommended by
all clinician groups for treatment of anxiety/depression.
Conclusion This exploratory study demonstrated a lack of consensus between clinician groups in their
investigation, diagnosis and management of early menopause in women with breast cancer, with implications
for both diagnosis and treatment.
AB - Objective Investigation of clinicians ? understanding of early menopause diagnosis/management in women
with breast cancer.
Methods A cross-sectional study of 176 randomly recruited Australian clinicians (35 gynecologists, 35
endocrinologists, 36 oncologists, 35 breast surgeons and 35 general practitioners (GPs)) involved in the care
of women with breast cancer. This questionnaire study utilized an index case to assess understanding of early
menopause diagnosis and management. Analysis involved descriptive statistics, ? 2 tests and Student ? s t -test.
Results Signifi cant differences between clinician groups regarding diagnostic criteria for early menopause
were observed; gynecologists, endocrinologists and GPs selected amenorrhea 12 months , whereas oncologists
and breast surgeons selected elevated serum follicle stimulating hormone level ( p 0.05). Non-hormonal
treatment was preferred by most clinician groups. Complementary/alternative medicines were more commonly
prescribed by breast surgeons (57 ), gynecologists (54 ) and endocrinologists (49 ) compared to oncologists
(28 ) or GPs (9 ) ( p 0.0001). Exercise (63 ) and nutrition (66 ) were selected by most gynecologists
for treatment of hot fl ushes, whereas endocrinologists (91 ), oncologists (94 ), breast surgeons (69 )
and GPs (63 ) prescribed venlafaxine. Hormone therapy was mainly prescribed by breast surgeons (43 )
compared to other groups ( p 0.001). Most clinicians reported that the main problem with menopausal
therapies was failure to resolve hot fl ushes. Exercise, lifestyle and stress management were recommended by
all clinician groups for treatment of anxiety/depression.
Conclusion This exploratory study demonstrated a lack of consensus between clinician groups in their
investigation, diagnosis and management of early menopause in women with breast cancer, with implications
for both diagnosis and treatment.
UR - http://informahealthcare.com/doi/pdf/10.3109/13697137.2013.765842
U2 - 10.3109/13697137.2013.765842
DO - 10.3109/13697137.2013.765842
M3 - Article
VL - 16
SP - 479
EP - 489
JO - Climacteric
JF - Climacteric
SN - 1369-7137
IS - 4
ER -