Description
Breast cancer is the most common cancer diagnosis among American women with the exception of skin cancer. The risk of recurrence of breast cancer after treatment is substantial. The Women's Healthy Eating a Living (WHEL) study was a randomized trail determining if a diet high in vegetables, fruit, and fiber and low in fat would reduce the risk of recurrent and new primary breast cancer and mortality among women with previously treated early stage breast cancer. The WHEL study found that women who reported hot flashes were less likely to develop recurrent breast cancer and they had significantly lower estradiol levels. The primary purpose of this study was to determine the cross-sectional association of hot flash status and circulating estradiol levels among breast cancer survivors in the WHEL study. The secondary purpose of this study was to determine the association of the one year change in hot flash status and estradiol levels among breast cancer survivors. Of the 1280 women in the study, 47.8% reported hot flashes and 52.2% did not report hot flashes. The association between baseline hot flashes and circulating estradiol was dependent on the menopause status of the women in the study. The only significant finding for the baseline association was in perimenopausal women: increased log estradiol was associated with lower odds of hot flashes. There was a significant negative association between the one year change in log estradiol and the one year change in hot flashes. The pathophysiology of hot flashes is not well understood and the results from this study support the hypothesis that estrogen withdrawal plays an important role in the occurrence of hot flashes. Since hot flashes were found to be protective against future breast cancer, it is important to understand the causal pathway that leads to a hot flash. This understanding will enable physicians to better treat breast cancer patients and to prevent a recurrence of the cancer
