Management of Gynecologic Issues in Women With Breast Cancer

Publication Date: March 1, 2012
Last Updated: March 14, 2022

Recommendations and Conclusions 

The following recommendation and conclusion is based on good and consistent scientific evidence. 

SSRIs and SNRIs have both been shown to be safe and to reduce the severity of hot flushes in patients with breast cancer, although caution must be used when using these agents in conjunction with tamoxifen. Gabapentin and clonidine are other options for management of hot flushes.

The following recommendations and conclusions are based on limited or inconsistent scientific evidence.

  • The 2009 National Comprehensive Cancer Network Task Force report recommends that pharmacologic therapy should be considered for women with breast cancer who have T scores between -1.5 and -2.0.
  • Routine endometrial biopsy and uterine ultrasonography are not recommended for postmenopausal women taking tamoxifen without bleeding.
  • Contraceptive options for patients with breast cancer include barrier methods, such as condoms and diaphragms, the copper intrauterine device, and sterilization.
  • Pregnancy after breast cancer is not thought to increase breast cancer recurrence.
  • If future pregnancy is desired for women in whom breast cancer has been diagnosed, appropriate consultation with fertility specialists should be offered to ascertain whether immediate assisted reproductive strategies are possible to preserve fertility.

The following recommendation is based primarily on consensus and expert opinion.

Nonhormonal methods should be considered first-line treatment for vaginal atrophy in women with a history of hormone-sensitive breast cancer.

Recommendation Grading




Management of Gynecologic Issues in Women With Breast Cancer

Authoring Organization

Publication Month/Year

March 1, 2012

Last Updated Month/Year

January 9, 2023

Document Type


External Publication Status


Country of Publication


Inclusion Criteria

Female, Adult, Older adult

Health Care Settings


Intended Users

Physician, nurse nurse midwife, nurse certified nurse midwife, nurse, nurse practitioner, physician assistant



Diseases/Conditions (MeSH)

D001943 - Breast Neoplasms


breast cancer, Gynecologic Issues