Estrogen Deprivation Effects of Endocrine Therapy in Breast Cancer Patients: Incidence, Management and Outcome

September 2023 in “ Cancer Treatment Reviews ”

Linda Cucciniello, Giovanna Garufi, Rossana Di Rienzo, Claudia Martinelli, Giuliana Pavone, Mario Giuliano, Grazia Arpino, Filippo Montemurro, Lucia Del Mastro, Michelino De Laurentiis, Fabio Puglisi

endocrine therapy estrogen deprivation hormone receptor-positive vasomotor symptoms genitourinary syndrome of menopause bone density loss

Studysummary This review highlights the possible impact of side effects from endocrine therapy on quality of life, emphasizing that these can lead to poor adherence and early treatment discontinuation in patients with hormone receptor positive early breast cancer, potentially worsening survival outcomes.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

Endocrine therapy (ET) is crucial for treating hormone receptor-positive early breast cancer but leads to significant side effects due to estrogen deprivation, impacting patients' quality of life and treatment adherence. Common side effects include vasomotor symptoms, musculoskeletal disorders, genitourinary syndrome, fatigue, psychological disorders, ocular toxicity, dysmetabolic effects, and bone density loss. Alopecia affects up to 9% of patients on tamoxifen and 2.5% on aromatase inhibitors, with minoxidil being effective for management. The review emphasizes a multidisciplinary approach, using both pharmacological and non-pharmacological strategies, to manage these adverse events. It also notes that testosterone and omega-3 fatty acids may alleviate some symptoms but not joint pain from aromatase inhibitors. The POSITIVE trial indicates that temporary ET suspension for pregnancy is safe, and lifestyle interventions are recommended for managing side effects, as effective pharmacological solutions are limited.

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