Carpal tunnel syndrome and musculoskeletal symptoms in postmenopausal women with early breast cancer treated with exemestane or tamoxifen after 2–3 years of tamoxifen: a retrospective analysis of the Intergroup Exemestane Study

2012 ◽  
Vol 13 (4) ◽  
pp. 420-432 ◽  
Author(s):  
J Sven D Mieog ◽  
James P Morden ◽  
Judith M Bliss ◽  
R Charles Coombes ◽  
Cornelis JH van de Velde
Keyword(s):  
Breast Cancer ◽  
Carpal Tunnel Syndrome ◽  
Postmenopausal Women ◽  
Retrospective Analysis ◽  
Early Breast Cancer ◽  
Carpal Tunnel ◽  
Musculoskeletal Symptoms ◽  
Tunnel Syndrome

Aromatase Inhibitor–Induced Carpal Tunnel Syndrome: Results From the ATAC Trial

2009 ◽  
Vol 27 (30) ◽  
pp. 4961-4965 ◽  
Author(s):  
Ivana Sestak ◽  
Francisco Sapunar ◽  
Jack Cuzick
Keyword(s):  
Breast Cancer ◽  
Carpal Tunnel Syndrome ◽  
Postmenopausal Women ◽  
Early Breast Cancer ◽  
Carpal Tunnel ◽  
Hormone Replacement ◽  
Moderate Intensity ◽  
Tunnel Syndrome ◽  
Treatment Medication

Purpose Carpal tunnel syndrome (CTS) is a condition in which the median nerve is compressed, leading to pain and muscle weakness in the fingers and hand. Aromatase inhibitors lead to profound estrogen suppression and may be expected to increase the risk of CTS in postmenopausal women receiving adjuvant therapy for early breast cancer. Patients and Methods The current analyses were based on the 100-month median follow-up data in postmenopausal women in the two monotherapy arms (anastrozole, n = 3,092; tamoxifen, n = 3,094). Here, we investigate the natural history of patients who presented with CTS during adjuvant treatment for breast cancer and the relative importance of a range of known risk factors for CTS. Results After 100 months of follow-up, 80 cases (2.6%) of CTS were reported in the anastrozole arm, compared with 23 cases (0.7%) in the tamoxifen arm (P < .0001). The majority of CTS cases were reported as mild to moderate intensity and occurred early. None of the women stopped treatment medication as a result of CTS. CTS was significantly increased for women who used prior hormone replacement therapy (P = .007) or received prior chemotherapy (P = .01). Those who were 60 years of age or older at entry were at lower risk of CTS compared with their counterparts (P = .002). Conclusion Although the use of anastrozole is associated with a greater incidence of CTS, it is rare, and most cases were of mild to moderate intensity and short duration. CTS has little impact on the overall risk-to-benefit ratio for the use of anastrozole in postmenopausal women with early breast cancer.

scholarly journals Anastrozole-Induced Carpal Tunnel Syndrome: Results From the International Breast Cancer Intervention Study II Prevention Trial

2016 ◽  
Vol 34 (2) ◽  
pp. 139-143 ◽  
Author(s):  
Francesco Spagnolo ◽  
Ivana Sestak ◽  
Anthony Howell ◽  
John F. Forbes ◽  
Jack Cuzick
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Odds Ratio ◽  
Intervention Study ◽  
Musculoskeletal Symptoms ◽  
Increased Risk ◽  
Tunnel Syndrome ◽  
Cancer Intervention

Purpose Carpal tunnel syndrome (CTS) occurs when the median nerve is compressed at the wrist in the carpal tunnel. It has been suggested that hormonal risk factors may be involved in the pathogenesis of CTS, and a higher incidence of CTS has been reported in randomized clinical trials with aromatase inhibitors (AIs) compared with tamoxifen. Patients and Methods This was an exploratory analysis of the International Breast Cancer Intervention Study II, a double-blind randomized clinical trial in which women at increased risk of breast cancer were randomly assigned to receive anastrozole or placebo. This is the first report of risk factors for and characteristics of CTS in women taking an AI in a placebo-controlled trial. Results Overall, 96 participants with CTS were observed: 65 (3.4%) in the anastrozole arm and 31 (1.6%) in the placebo arm (odds ratio, 2.16 [1.40 to 3.33]; P < .001). Ten participants were reported as having severe CTS, of which eight were taking anastrozole (P = .08). Eighteen women (0.9%) in the anastrozole arm and six women (0.3%) in the placebo arm reported surgical intervention, which was significantly different (odds ratio, 3.06 [1.21 to 7.72], P = .018). Six women discontinued with the allocated treatment because of the onset of CTS. Apart from treatment allocation, a high body mass index and an a prior report of musculoskeletal symptoms after trial entry were the only other risk factors for CTS identified in these postmenopausal women. Conclusions The use of anastrozole was associated with a higher incidence of CTS but few participants required surgery. Further investigations are warranted into the risk factors and treatment of AI-induced CTS.

scholarly journals Aromatase Inhibitors and Risk of Arthritis and Carpal Tunnel Syndrome among Taiwanese Women with Breast Cancer: A Nationwide Claims Data Analysis

2020 ◽  
Vol 9 (2) ◽  
pp. 566 ◽  
Author(s):  
Hsu-Chih Chien ◽  
Yea-Huei Kao Yang ◽  
C. Kent Kwoh ◽  
Pavani Chalasani ◽  
Debbie L. Wilson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Cancer Recurrence ◽  
Research Database ◽  
Taiwanese Women ◽  
Increased Risk ◽  
Significant Difference ◽  
Tunnel Syndrome ◽  
Claims Data Analysis

Tamoxifen or aromatase inhibitor (AI) therapy may prevent breast cancer recurrence, however, adverse effects may lead to treatment discontinuation. Evidence regarding the occurrence of AI-associated musculoskeletal problems among Asians is scarce. We identified women with breast cancer-initiating tamoxifen or AIs from the Taiwan National Health Insurance Research Database (2007–2012). Using multivariable cause-specific hazard models, we examined the association between endocrine therapy and the risk of any arthritis and carpal tunnel syndrome, adjusting for age, prior cancer treatment, and other health status factors. Among 32,055 eligible women with breast cancer (mean age = 52.6 ± 11.5 years), 87.4% initiated tamoxifen, 3.9% initiated anastrozole, 8.0% initiated letrozole, and 0.7% initiated exemestane. AI users had a higher 1-year cumulative incidence for any arthritis (13.0% vs. 8.2%, p < 0.0001) and carpal tunnel syndrome (1.4% vs. 0.8%, p = 0.008). Compared to tamoxifen users, AI users had a higher risk of any arthritis [adjusted hazard ratio (aHR) = 1.21, 95%CI = 1.09–1.34] and carpal tunnel syndrome (aHR = 1.68, 95%CI = 1.22–2.32). No significant difference was observed in the risks of any arthritis and carpal tunnel syndrome across different AIs. Taxane use was not associated with any arthritis (aHR = 0.92, 95%CI = 0.81–1.05) or carpal tunnel syndrome (aHR = 0.97, 95%CI = 0.67–1.40) compared to other chemotherapies. Taiwanese women with breast cancer-initiating AIs had an increased risk of arthritis and carpal tunnel syndrome compared to those who initiated tamoxifen.

scholarly journals What Types of Treatment Are Provided for Patients With Carpal Tunnel Syndrome? A Retrospective Analysis of Commercial Insurance

PM&R ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 826-835 ◽  
Author(s):  
Nancy A. Baker ◽  
Joel M. Stevans ◽  
Lauren Terhorst ◽  
Allen M. Haas ◽  
Yong-Fan Kuo ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Retrospective Analysis ◽  
Carpal Tunnel ◽  
Commercial Insurance ◽  
Tunnel Syndrome

Carpal tunnel syndrome in breast cancer survivors with upper extremity lymphedema

2015 ◽  
Vol 51 (6) ◽  
pp. 864-869 ◽  
Author(s):  
Michael D. Stubblefield ◽  
Arum Kim ◽  
Elyn R. Riedel ◽  
Katarzyna Ibanez
Keyword(s):  
Breast Cancer ◽  
Carpal Tunnel Syndrome ◽  
Cancer Survivors ◽  
Upper Extremity ◽  
Carpal Tunnel ◽  
Breast Cancer Survivors ◽  
Tunnel Syndrome

scholarly journals Surgical Treatment of Carpal Tunnel Syndrome and Lymphedema in Advanced-Stage Upper Extremity Lymphedema

2021 ◽  
Author(s):  
Soo-Byn Kim ◽  
Kyung-Chul Moon
Keyword(s):  
Breast Cancer ◽  
Carpal Tunnel Syndrome ◽  
Upper Extremity ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Adjuvant Chemoradiotherapy ◽  
Axillary Lymph ◽  
Advanced Stage ◽  
Transverse Carpal Ligament ◽  
Tunnel Syndrome

Abstract Background Recent advances in supermicrosurgery have evolved to treat lymphedema surgically. For patients with carpal tunnel syndrome (CTS) and advanced-stage lymphedema, lymphovenous anastomosis (LVA) may effectively improve lymphedema after carpal tunnel release in patients with CTS and advanced stage lymphedema. However, no studies have reported simultaneous carpal tunnel release and LVA surgeries for patients with CTS and advanced-stage lymphedema.Case Presentation A 60-year-old female with carpal tunnel syndrome and International Society of Lymphology late stage 2 right upper extremity lymphedema following right mastectomy and axillary lymph node dissection and adjuvant chemoradiotherapy for treating breast cancer was admitted to our lymphedema clinic. She developed carpal tunnel syndrome four years after breast cancer surgery. She underwent release of the transverse carpal ligament, followed by four lymphovenous anastomoses at the wrist, forearm, and antecubital area. After two simultaneous surgeries, she had less neuropathic pain and volume reduction in her hand.Conclusion The authors recommend simultaneous LVA and release of the transverse carpal ligament as the first treatment option for patients with advanced-stage lymphedema and concurrent CTS.

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