[AlaskaAngel]

Your question is an especially important one for people at high risk for breast cancer and for those who have breast cancer. And your question is not being asked often enough and is not being honestly answered by the medical profession.

The problem is that so many medical providers and patients continue to rely too heavily on the very rough guideline that says that one is menopausal if one has not had a period for one year. The North American Menopause Society uses that definition for the group of all women, in their directions under "Confirming Menopause". It may be okay to use it as a very rough guideline for the entire group of women in general, but not for those who are trying to use it in a more crucial situation like breast cancer.

There is debate out there about how reliable that simple definition is, and about how reliable measuring hormonal levels is, because they may or may not provide an accurate picture, due to the results of hormonal testing being static and the actual patient's hormonal testing being fluctuational.

Some women do not become fully menopausal even into their late 60's and early 70's. The average age is 51.

I see patients and medical providers using the rule of thumb over and over as if it provided definite justification for thinking the patient is truly fully menopausal, yet no one has actually demonstrated that is true or to what degree it is true, and there is some information to the contrary.

It may also be true that people who develop breast cancer are more likely than the general female population to be less likely to become fully menopausal until a later age, if at all.

Despite the greater need in particular to more fully investigate the hormonal process in behalf of women who are at higher risk for bc or who have developed bc to get a better understanding of how hormonal development and cancer are related, it has taken a back burner to research for toxic treatments of breast cancer.

Breast cancer aside, there is clear question about the validity of the rule of thumb based on the unexpected pregnancies that continue to occur for some supposedly "menopausal" women.

This raises a question about the value of chemotherapy in comparison to the use of ovarian suppression by other means or by surgical removal. A clinical trial has been in progress for a long time about this question, and I don't know if there have been any preliminary results reported out or not. A previous clinical trial done with chemotherapies that at that time did not include taxanes demonstrated that the use of CAFx6 plus tamoxifen was equal to ovarian ablation.

The question remains, is chemotherapy less effective or more effective in dealing with hormonal influence? Since chemotherapy is used to bring about the apoptosis of cancer cells yet it doesn't seem to bring about the death of stem cells, it may be that complete removal of the ovaries is actually superior in some ways to chemotherapy, even though some amounts of hormones are produced in other areas of the body.

On a personal basis, I was not fully menopausal after completion of chemotherapy at age 52, but by symptoms was more fully menopausal after 3 months of tamoxifen that I took after having chemotherapy. (I have never had my ovaries removed.)