Postmenopausal women with breast cancer adapt well to endocrine therapy

Key takeaways :

• All women had high quality of life scores throughout follow-up.
• Women receiving tamoxifen had better quality of life in functioning, symptoms and emotional areas compared with aromatase inhibitor therapy.

Postmenopausal women with early-stage breast cancer adapted successfully to the disease and endocrine therapy whether it was tamoxifen or aromatase inhibitor, researchers reported in Menopause.

“In this study, we assess quality of life in a sample of Spanish postmenopausal early-stage breast cancer patients who received endocrine therapy for 5 years,” Juan Ignacio Arraras, PhD, from the departments of medical oncology and radiotherapeutic oncology at the University Hospital of Navarra in Pamplona, Spain, and colleagues wrote. “We also assess changes in quality of life after endocrine therapy cessation and examine the differences between the two endocrine therapy modalities: tamoxifen or aromatase inhibitor.”

This prospective cohort study included 130 postmenopausal women with early-stage breast cancer who received tamoxifen (n = 24; mean age, 64.4 years) or aromatase inhibitor (n = 106; mean age, 71.2 years) therapy for 5 years. Some women may have changed therapy type during the 5-year period. All women also completed the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-BR45 questionnaires at baseline, 6 months and 1 year after ending endocrine therapy. Those who were older than 65 years completed the QLQ-ELD14 questionnaire.

Throughout follow-up, researchers observed high quality of life scores (> 80 of 100 points) for all women for most quality of life assessment areas. Women who completed the QLQ-BR45 questionnaire reported moderate limitations of 30 points or more in sexual functioning and sexual enjoyment, future perspective and joint symptoms. Women who completed the QLQ-ELD14 questionnaire reported moderate limitations in worries about others, maintaining purpose, joint stiffness, future worries and family support.

Among women who completed 5 years of endocrine therapy, pain reduced in all three quality of life assessments during the 1-year follow-up period for both tamoxifen and aromatase inhibitor groups. Women who received tamoxifen had higher quality of life scores in functioning, symptoms and emotional areas compared with women who received aromatase inhibitor. However, women receiving tamoxifen had lower quality of life scores for mucosis symptoms than those in the aromatase inhibitor group.

“Clinical studies on treatments for alleviating the adverse effects of endocrine therapy would be useful, as would studies to evaluate whether changing to tamoxifen in patients who have received aromatase inhibitor for a number of years has a positive effect on their quality of life,” the researchers wrote. “Future research could also focus on the differences in quality of life, for example, between endocrine therapy modalities after a longer follow-up period, in a larger sample of patients from different cultural areas or by adjuvant treatment modality. It would also be interesting to assess the role of disease recurrence on quality of life in these patients.”