Speakers - 2026

Title: Patient reported experience of management of menopausal symptoms related to endocrine therapy for breast cancer at University Hospitals Birmingham NHS Foundation Trust

Abstract

Introduction:

In the UK, breast cancer accounts for 15% of newly diagnosed cancers and 30% of newly diagnosed cancers in females. Over two thirds of patients have hormone receptor positive disease where endocrine therapy with or without ovarian suppression represents an integral part of the treatment pathway. Endocrine therapy often induces menopausal symptoms including vasomotor symptoms, genitourinary symptoms, joint pains, low libido, brain fog, mood disturbances, and many more. These symptoms are often under-recognised and sub-optimally managed, in part due to lack of dedicated services and capacity pressures. If not adequately addressed, they can negatively impact quality of life and adherence to treatment and ultimately, a poorer outcome. 

Methods:

This quality improvement project aimed at investigating the management of menopausal symptoms in individuals undergoing endocrine breast cancer therapy at Solihull Hospital, University Hospitals Birmingham NHS Foundation Trust. 

In May 2025, a small audit demonstrated that 10 of 35 consecutive patients who visited a single breast oncology clinic at Solihull Hospital experienced significant menopausal side effects affecting their quality of life. 3 of these 10 patients stopped endocrine therapy, with 5 others switching treatments. 

Subsequently, a patient focused, anonymized survey was developed, addressing patients’ experience of menopausal symptoms and their perception of how adequately these symptoms are being managed by their oncology and breast care teams. Patients were asked about their specific symptoms and how well they felt each of these symptoms was being managed: from well managed to not managed at all.  

Results:

We received a total of 21 responses. Of these, 86% experienced hot flushes and only 50% of these patients felt that they were adequately managed. 90% experienced brain fog, with 42% of them denying that any management was offered. 52% reported experiencing vaginal dryness, with only 27% reporting adequate management 

Significantly, 95% of patients reported muscle aches with 50% reporting adequate management and 62% reported low mood, with the same number reporting loss of libido. 

The survey found adequate measures were being implemented to ensure bone health is being monitored with appropriate intervention when required in the majority of cases. 

Conclusion: 

This project demonstrates that menopausal symptoms impact many individuals undergoing endocrine breast cancer therapy and highlights the urgent need to improve the service offered at University Hospitals Birmingham. Based on these results, Solihull Hospital has started a multidisciplinary menopause and breast cancer clinic to provide a holistic approach to the complex needs of patients presenting with menopausal symptoms related to breast cancer treatments.

What will they take away from the presentation:

• Understanding the variety of menopausal symptoms people experience when undergoing hormonal breast cancer therapy.
• To acknowledge the vast room for improvement in the management of these symptoms in the University Hospitals Birmingham Trust.
• To reflect and consider investigating the management in your respective hospital trusts.
• To aim to do similar projects and consider funding your own menopause/ oncology clinics if there is similar room for improvement