One of the FAQs about breast cancer: is menopause after chemo real? Not always.

Because breast cancer is strongly associated with obesity, breast cancer patients need to manage their weight throughout their lives. So, how should breast cancer patients manage their weight?

“It is important to exercise regularly because it is important to manage weight in breast cancer,” said Professor Kang Eun-hye of the Department of Breast and Endocrine Surgery at Seoul National University Hospital (SNUH) on the “SNUH TV.

During chemotherapy, the chemotherapy drugs can affect the ovaries, so the ovarian function may decrease, leading to early menopause. However, this may not be true menopause. (Credit: Getty Images)

One thing breast cancer patients should be careful about in their daily routine after surgery is to avoid lifting heavy objects with their operated arm. Professor Jung Ji-jung of the same department said, “The arm on the operated side may have lymphedema or muscle weakness, so it's better to lift heavy objects with the opposite arm,”

After a breast cancer diagnosis, many women are interested in supplements to help them stay healthy, but there are some caveats. “You shouldn't take supplements that you don't know the exact ingredients of,” Professor Kang said.

Breast cancer patients should not take supplements for menopausal women. “Older breast cancer patients often take menopausal supplements, which may unknowingly contain female hormones, so I advise them to avoid them altogether,” Kang advised.

When taking hormone therapy for breast cancer, it's a good idea to avoid other medications. However, is it necessary to avoid even over-the-counter painkillers?

“You can take OTC painkillers without a doctor's prescription because there's nothing wrong with them,” Professor Jung said.

Do patients who have already had one breast removed for breast cancer not need regular mammograms? The answer is “no.”

“Even if you've had a total mastectomy, it's still essential to get regular checkups,” Jung said. “Patients with breast cancer in one breast have a slightly increased risk of developing breast cancer in the other than the general population.”

For this reason, breast cancer patients should be more diligent about breast cancer screening than the general population.

“We recommend mammograms once a year on the opposite breast,” Professor Jung said. “If you are younger and have dense breasts, you’d better add an ultrasound.”

Women often think of pain as a sign of breast cancer recurrence. Is it true, however? Not really.

“Just because you're in pain doesn't mean your cancer is coming back,” Jung said. “You don't have to make the connection between pain and recurrent breast cancer.”

The sign of breast cancer recurrence is usually lumpiness, not pain.

“The symptom of recurrence is usually (lumpiness) rather than pain,” Professor Kang noted, explaining that the area where the surgery was performed may have a natural lumpiness due to fibrosis of the surrounding tissue after surgery. However, if the lumpiness is in a different area or the original lumpiness is larger, it may be a sign of breast cancer recurrence.

There is another sign of breast cancer recurrence. This is when the skin around the breast changes shape. “Some patients present with changes in the shape of the skin around the breast, such as indentations,” Kang said.

Can breast cancer patients take menopause hormone therapy when menopause symptoms occur? Some breast cancer patients can, and some can't, but there's a difference -- whether they receive hormone therapy or not.

“There are many patients who take antihormonal therapy after breast cancer surgery, and they complain of more menopausal symptoms. Patients who are taking antihormonal therapy should not take menopausal hormone therapy,” Kang said, emphasizing the need to consult with a medical team before taking menopausal therapy.

Is it true that chemotherapy can accelerate menopause in breast cancer patients?

“During chemotherapy, the chemotherapy drugs themselves can affect the ovaries, so the ovarian function may decrease, leading to early menopause,” Kang explained.

However, this may not be true menopause. “Even if it looks like menopause has occurred, the menstrual period could return in two years or so,” Kang said. “It takes some time to know if it is true that menopause has occurred right after chemotherapy.”

When vaccinating after breast cancer surgery, can they get an injection in the arm where they had breast cancer surgery? “I would advise against getting the shot in the arm where the surgery was performed because it can cause lymphedema,” Kang said.

Is there a time when breast cancer patients shouldn't get vaccinated? When you're undergoing chemotherapy, your immune system is low, and you shouldn't get vaccinated. However, after chemotherapy is over, vaccinations are necessary. “Even if you have breast cancer, we recommend that you get vaccinated once you finish treatment,” Professor Jung said.

Some people say that vaccinations interfere with breast cancer screening. Why?

“Usually, when I get vaccinated, my armpit lymph nodes on the opposite arm swell slightly. That's a normal reaction, but because of that, there are some cases where it's a little confusing whether there's a risk of recurrence or not when it comes to breast cancer screening,” Professor Kang said.