Update on adjuvant hormonal treatment of early breast cancer

Abstract Background The standard adjuvant endocrine treatment for postmenopausal female patients with hormone receptor positive early breast cancer was 5 years of tamoxifen, but recurrence and side effects restrict its usefulness. The aromatase inhibitor (anastrozole or exemestane or letrozole) was compared with tamoxifen for 5 years or started after completing 2-3 years of tamoxifen in postmenopausal female patients diagnosed with early breast cancer at "Ain Shams University Hospitals" Objective The aim of the study was to measure survival outcome and treatment tolerability for postmenopausal females with Hormone Receptor Positive early breast cancer who received adjuvant hormonal treatment with tamoxifen [TAM] only for 5 years versus those who received adjuvant hormonal treatment with tamoxifen [TAM] for 2 years switching to aromatase inhibitors [AI] in the sequential 3 years versus those who received adjuvant hormonal treatment with aromatase inhibitors [AI] solely for 5 years. Patients and methods This study included 100 postmenopausal women with early breast cancer who presented at the Clinical Oncology Department, Ain Shams University, in the interval from January 2010 until December 2015. Conclusion Similar disease free survival and overall survival were observed among the three studied groups. Switching tamoxifen to aromatase inhibitors provides better tolerability in terms of endometrial thickness when compared to 5 years of tamoxifen monotherapy. Patients who administer aromatase inhibitor included in the switching strategy experience less osteoporosis and less generalized bone pain compared to upfront aromatase inhibitor to 5 years. There was a significant improvement of disease free survival (DFS) in human epidermal growth factor receptor 2 (HER 2) negative patients receiving any adjuvant hormonal treatment line for five years in comparison to HER 2 positive patients receiving the same adjuvant hormonal treatment for five years.

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Investigation of herb-drug interactions with ginkgo biloba in women receiving hormonal treatment for early breast cancer

SpringerPlus ◽

10.1186/2193-1801-2-126 ◽

2013 ◽

Vol 2 (1) ◽

pp. 126 ◽

Cited By ~ 12

Author(s):

Janette Vardy ◽

Haryana M Dhillon ◽

Stephen J Clarke ◽

Inger Olesen ◽

Felicity Leslie ◽

...

Keyword(s):

Breast Cancer ◽

Drug Interactions ◽

Early Breast Cancer ◽

Ginkgo Biloba ◽

Hormonal Treatment

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Modulation of tamoxifen adjuvant hormonal treatment according to first generation prognostic factors in 702 pT1-2/pN0-1(≤3)/M0 breast cancer, treated by surgery and external irradiation

European Journal of Cancer ◽

10.1016/s0959-8049(97)84783-1 ◽

1997 ◽

Vol 33 ◽

pp. S84

Author(s):

M. Bolla ◽

P. Winckel ◽

M. Colonna ◽

M. Chédin ◽

M.H. Panh ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

First Generation ◽

Hormonal Treatment ◽

External Irradiation ◽

Adjuvant Hormonal Treatment

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Effects of ‎tamoxifen on the reproductive system of female breast cancer patients: an ultrasound-based cohort study

F1000Research ◽

10.12688/f1000research.21481.1 ◽

2020 ◽

Vol 9 ◽

pp. 102

Author(s):

Ghasak Kais Abd-Alhussain‎ ◽

Mohammed Qasim Yahya Mal-Allah Alatrakji‎ ◽

Wieeam Abdulfattah Saleh‎ ◽

Hayder Adnan Fawzi ◽

Aqeel‎ Shaker Mahmood‎

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Side Effects ◽

Endometrial Thickness ◽

Menopausal Status ◽

Hormonal Treatment ◽

Female Breast Cancer ◽

Breast Cancer Patients ◽

Er Positive ◽

Adjuvant Hormonal Treatment

Background: Tamoxifen (TMX) is regarded as standard treatment for breast cancer (BC) patients‎. In recent years, several studies have reported gynecological side effects and due to TMX's estrogenic effects. Here, we evaluate the side effects of TMX on the ‎endometrium and ovaries of female BC patients. Methods: This was an ultrasound-based cohort study conducted in three oncology centers in Baghdad, Iraq. A total of ‎‎255 female patients were included, 140 premenopausal (PreM) and 115 postmenopausal (PostM), with estrogen receptor (ER)-positive BC using TMX adjuvant hormonal treatment for at least three months after surgery and adjuvant ‎chemo/radiotherapy.‎ Ultrasound (US) on the endometrium and ovaries of the women following ‎BC surgery/chemotherapy (baseline) and at 3, 6, 12, and 24 months following was performed‎. Data collected included age, menopausal status, co-morbid chronic illness and medications, including duration of TMX treatment. Results: Presence of ovarian cyst was significantly higher in the PreM ‎compared to PostM ‎women, while there were no significant differences for other gynecological findings.‎ At ‎baseline, endometrial thickness (ET) was significantly higher in the PreM compared to the PostM women. In both groups, women with increased ET became more frequent from baseline to 3 ‎months, from 3 to 6 ‎months, from 6 to 12 months, and from 12 ‎ to 24 months. At all time periods, ‎women with increased ET was ‎significantly higher in the PostM compared PreM women, resulting ‎in a risk of ET increase by 6 folds (ranging from 3 – ‎‎11 folds) ‎in PostM compared to PreM women. Conclusions: Longer duration of TMX is associated with increased ET. Duration of TMX did not appear to increase the risk of various gynecological outcomes, for example endometrial cancer rate was low. Finally, there was an increase in ET, which appeared to be six-folds higher in PostM compared to PreM women.‎

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Adherence to adjuvant hormonal treatment for breast cancer in patients opting for local hospital direct drug distribution in Italy

European Journal of Hospital Pharmacy ◽

10.1136/ejhpharm-2012-000244 ◽

2013 ◽

Vol 20 (4) ◽

pp. 232-235

Author(s):

Marianna Rivasi ◽

Raffaella Apollonio ◽

Laura Cancian ◽

Teresa Pilade ◽

Mauro De Rosa

Keyword(s):

Breast Cancer ◽

Drug Distribution ◽

Hormonal Treatment ◽

Local Hospital ◽

Adjuvant Hormonal Treatment

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Anthracycline-containing regimen in early breast cancer: Analysis of toxicity

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.11104 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 11104-11104

Author(s):

A. I. Jagiello-Gruszfeld ◽

A. Lowczak ◽

J. Zbrzezniak-Smilgiewicz ◽

S. Szablowska-Siwik ◽

G. Licznerska ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Early Breast Cancer ◽

Risk Group ◽

Internet Access ◽

Hormonal Treatment ◽

Intermediate Risk ◽

Adjuvant Setting ◽

Grade 3

11104 Background: The anthracycline-containing regimens is considered to be more beneficial to patients (pts) with early breast cancer (EBC). However at this moment is not clear which kind of regimen should be used in adjuvant setting. Methods: In our center, from Jan 2004 to Sep 2006, 248 breast cancer pts, who were qualified to the adjuvant chemotherapy received FEC100 (104 pts), AC (126 pts). or sequentially AC- taxans (18). Pts with many poor prognostic factors (N+, T3, G3, HER2/neu 3+) received 6 cycles of FEC100 or AC-taxans. Pts with better prognosis (Intermediate Risk Group according St.Gallen’s guidelines for 2005) received usually 4 cycles of AC. Besides, in most cases, internet access to the adjuvantonline! program was used during making decision. ER-ve or PR-ve positive pts received sequentially hormonal treatment. The radiotherapy (if needed) was delivered at the end of the chemotherapy. Results: During the treatment, toxicity of the chemotherapy was evaluated by NCI CTC v. 3. There was no toxic deaths. Median follow-up period was 19 months (range: 6–36). The febrile neutropenia was observed in 4 pts in FEC100 and in 5 pts in AC group. There was also no significant differences in the grade 3 or 4 neutropenia, anemia, thrombocytopenia and alopecia. In 3 pts treated with FEC100 and 1 with AC, cardiotoxicity grade 2 or 3 was diagnosed. Grade 2 or 3 asthenia was frequent in FEC100 group (44% vs 21% vs11%). In all pts prophylaxis of nausea/vomiting was used. However pts treated with FEC100 needed more 5HT3. Vomiting grade 2 or 3 were observed significantly more often in pts who received FEC100 (58% vs 26% vs 23%). Only at 1 pts in each group the chemotherapy was interrupted due to toxicity (asthenia gr 3, vomiting gr 3 and weight loss gr 2). The relative dose intensities of FEC100 and AC were 87% and 96% of planned doses, respectively. Conclusions: The acute symptoms of toxicity were important for breast cancer pts who received the adjuvant chemotherapy. According the adjuvantonline! 6 cycles of FEC100 were more effective than 4 cycles of AC. Nevertheless tolerability of AC is better. Many pts prefer only the hormonal treatment, even if it is not the optimal option, in fear of nausea or vomiting. The ongoing clinical trials should further define the best choice of anthracycline-containing regimen in the adjuvant setting. No significant financial relationships to disclose.

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