Menopausa e câncer de mama: uma revisão narrativa dos fatores hormonais, terapêuticos e prognósticos
DOI:
https://doi.org/10.5281/zenodo.20416155Palavras-chave:
câncer de mama; menopausa; mulheres; hormôniosResumo
Introdução: o câncer de mama é uma neoplasia maligna caracterizada pela proliferação descontrolada de células, com potencial de metástase. A menopausa, marcada pela cessação da menstruação e pela queda de estrogênio e progesterona, cria um ambiente hormonal distinto.
Objetivo: analisar a relação entre menopausa e câncer de mama em mulheres na pré-menopausa, menopausa e pós-menopausa.
Método: realizou-se uma revisão bibliográfica narrativa mediante busca sistemática nas bases PubMed, Scopus e Web of Science, com uso de descritores e operadores booleanos.
Resultados: foram selecionados artigos em inglês publicados entre 2019 e 2024, resultando em nove estudos relevantes. As evidências revelam uma relação multifatorial. O estado menopausal influencia a eficácia das terapias; algumas mulheres na pós-menopausa com receptores positivos poderiam evitar a quimioterapia. A menopausa é crucial na escolha de terapias endócrinas e radioterápicas. Observa-se que fármacos como o denosumabe reduzem metástases ósseas, especialmente em mulheres na pré-menopausa. Fatores de estilo de vida mostram impacto modesto no risco, e biomarcadores com valor prognóstico foram identificados.
Considerações finais: a menopausa não é uma causa direta, mas constitui uma fase de alto risco, devido à idade, às mudanças hormonais e ao acúmulo de exposições. Compreender esse estado é vital para personalizar o tratamento e gerenciar o risco oncológico.
Downloads
Referências
Lei S, Zheng R, Zhang S, Wei W. The burden and long-term trends of breast cancer by different menopausal status in China. J Natl Cancer Cent [Internet]. 2024 [citado 15 Jul 2025]; 4(4):326–334. DOI: https://doi.org/10.1016/j.jncc.2024.04.007
Collaborative Group on Hormonal Factors in Breast Cancer. Menarche, menopause, and breast cancer risk: individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. Lancet Oncol [Internet]. 2012 [citado 15 Jul 2025]; 13 (11):1141–1151. DOI: https://doi.org/10.1016/s1470-2045(12)70425-4
Heer E, Harper A, Escandor N, Sung H, McCormack V, Fidler-Benaoudia MM. Global burden and trends in premenopausal and postmenopausal breast cancer: a population-based study. Lancet Glob Health [Internet]. 2020 [citado 15 Jul 2025]; 8(8):e1027–e1037. DOI: https://doi.org/10.1016/s2214-109x(20)30215-1
Tin Tin S, Reeves GK, Key TJ. Endogenous hormones and risk of invasive breast cancer in pre- and post-menopausal women: findings from the UK Biobank. Br J Cancer [Internet]. 2021 [citado 15 Jul 2025]; 125:126–134. DOI: https://doi.org/10.1038/s41416-021-01392-z
Ahern TP, Sprague BL, Farina NH, Tsai E, Cuke M, Kontos D, et al. Lifestyle, behavioral and dietary risk factors in relation to mammographic breast density in women at high risk for breast cancer. Cancer Epidemiol Biomarkers Prev [Internet]. 2021 [citado 15 Jul 2025]; 30(5):936–944. DOI: https://doi.org/10.1158/1055-9965.epi-20-1567
Sauder CAM, Li Q, Othieno A, Cruz D, Arora M, Bold RJ, et al. Characteristics and outcomes for secondary breast cancer in childhood, adolescent and young adult cancer survivors treated with radiation. Cancer Epidemiol Biomarkers Prev [Internet]. 2020 [citado 15 Jul 2025]; 29(9):1767–1774. DOI: https://doi.org/10.1158/1055-9965.epi-20-0260
Chen H, Cook LS, Tang M-TC, Hill DA, Wiggins CL, Li CI. Relationship between diabetes and diabetes meJulations and risk of different molecular subtypes of breast cancer. Cancer Epidemiol Biomarkers Prev [Internet]. 2019 [citado 15 Jul 2025]; 28(11):1802–1808. DOI: https://doi.org/10.1158/1055-9965.epi-19-0291
Kalinsky K, Barlow WE, Gralow JR, Meric-Bernstam F, Albain KS, Hayes DF, et al. 21-Gene assay to inform chemotherapy benefit in node-positive breast cancer. N Engl J Med [Internet]. 2021 [citado 19 Jun 2025]; 385(25):2336–2347. DOI: https://doi.org/10.1056/NEJMoa2108873
Mehta RS, Barlow WE, Albain KS, Vandenberg TA, Dakhil SR, Tirumali NR, et al. Overall survival with Fulvestrant plus Anastrozole in metastatic breast cancer. N Engl J Med [Internet]. 2019 [citado 15 Jul 2025]; 380(13):1226–1234. DOI: https://doi.org/10.1056/NEJMoa1811714
Vicini FA, Cecchini RS, White JR, Arthur DW, Julian TB, Rabinovitch RA, et al. Long-term primary results of accelerated partial breast irradiation after breast-conserving surgery for early-stage breast cancer: a randomised, phase 3, equivalence trial. The Lancet [Internet]. 2019 [citado 15 Jul 2025]; 394(10215):2155–2164. DOI: https://doi.org/10.1016/S0140-6736(19)32514-0
Guo Q, Pan K, Qiu P, Liu Z, Chen J, Lin J. Identification of an exosome-related signature associated with prognosis and immune infiltration in breast cancer. Sci Rep [Internet]. 2023 [citado 15 Jul 2025]; 13:18198. DOI: https://doi.org/10.1038/s41598-023-45325-7
Coleman R, Zhou Y, Jandial D, Cadieux B, Chan A. Bone health outcomes from the international, multicenter, randomized, phase 3, placebo-controlled d-care study assessing adjuvant denosumab in early breast cancer. Adv Ther [Internet]. 2021 [citado 15 Jul 2025]; 38(8):4569–4580. DOI: https://doi.org/10.1007/s12325-021-01812-9
Tesch H, Stoetzer O, Decker T, Kurbacher CM, Marmé F, Schneeweiss A, et al. Efficacy and safety of everolimus plus exemestane in postmenopausal women with hormone receptor‐positive, human epidermal growth factor receptor 2‐negative locally advanced or metastatic breast cancer: results of the single‐arm, phase IIIB 4EVER trial. Int J Cancer [Internet]. 2019 [citado 15 Jul 2025]; 144(4):877–885. DOI: https://doi.org/10.1002/ijc.31738
Von Holle A, Adami H-O, Baglietto L, Berrington de Gonzalez A, Bertrand KA, Blot W, et al. BMI and breast cancer risk around age at menopause. Cancer Epidemiol [Internet]. 2024 [citado 15 Jul 2025]; 89:102545. DOI: https://doi.org/10.1016/j.canep.2024.102545
García-Estévez L, Cortés J, Pérez S, Calvo I, Gallegos I, Moreno-Bueno G. Obesity and breast cancer: a paradoxical and controversial relationship influenced by menopausal status. Front Oncol [Internet]. 2021 [citado 19 Jun 2025]; 11. DOI: https://doi.org/10.3389/fonc.2021.705911
Pinkerton J V. Hormone therapy for postmenopausal women. N Engl J Med [Internet]. 2020 [citado 16 Jun 2025]; 382(5):446–455. DOI: https://doi.org/10.1056/nejmcp1714787
Jones ME, Schoemaker MJ, Wright L, McFadden E, Griffin J, Thomas D, et al. Menopausal hormone therapy and breast cancer: what is the true size of the increased risk? Br J Cancer [Internet]. 2016 [citado 16 Jun 2025]; 115(5):607–615. DOI: https://doi.org/10.1038/bjc.2016.231
Rozenberg S, Di Pietrantonio V, Vandromme J, Gilles C. Menopausal hormone therapy and breast cancer risk. Best Pract Res Clin Endocrinol Metab [Internet]. 2021 [citado 16 Jun 2025]; 35(6):101577. DOI: https://doi.org/10.1016/j.beem.2021.101577
Kang D, Kim J-Y, Kim J-Y, Mun HS, Yoon SJ, Lee J, et al. The relationship between breast density change during menopause and the risk of breast cancer in Korean Women. Cancer Prev Res (Phila) [Internet]. 2021 [citado 13 Nov 2025]; 14(12):1119–1128. DOI: https://doi.org/10.1158/1940-6207.capr-20-0542
Abubakar M, Zhang J, Ahearn TU, Koka H, Guo C, Lawrence SM, et al. Tumor-associated stromal cellular density as a preJultor of recurrence and mortality in breast cancer: results from ethnically diverse study populations. Cancer Epidemiol Biomarkers Prev [Internet]. 2021 [citado 21 Nov 2025]; 30(7):1397–1407. DOI: https://doi.org/10.1158/1055-9965.epi-21-0055
Houghton SC, Hankinson SE. Cancer progress and priorities: breast cancer. Cancer Epidemiol Biomarkers Prev [Internet]. 2021 [citado 21 Nov 2025]; 30(5):822–844. DOI: https://doi.org/10.1158/1055-9965.epi-20-1193
Lao C, Elwood M, Kuper-Hommel M, Campbell I, Lawrenson R. Impact of menopausal status on risk of metastatic recurrence of breast cancer. Menopause [Internet]. 2021 [citado 21 Nov 2025]; 28(10):1085–1092. DOI: https://doi.org/10.1097/gme.0000000000001817
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2026 Jessica Marcela Murillo Criollo, Jenniffer Estefania Rojas Yanza, Rosa Valeria Vargas Quezada, Joe Keller Sánchez-Salgado
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
