Management of hot flushes in UK breast cancer patients: clinician and patient perspectives

e22152 Background: Aromatase inhibitors (AI) are an important part of treatment of endocrine sensitive breast cancer. Adverse events in patients treated with AI’s often cause treatment discontinuation. The most common adverse events, such as arthralgia, myalgia and hot flushes are probably caused by estrogen deprivation and predict treatment efficacy. It is unclear which patients are at risk to develop these adverse events. The aim of this study was to examine if SNP’s in the CYP19A1 gene can predict the occurrence of adverse events in breast cancer patients treated with adjuvant exemestane. Methods: Patients of whom tissue was available and were selected from the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial. DNA was isolated from tumor samples and 30 SNPs were identified using a tagging SNP approach, aiming for 80% coverage of CYP19A1. Genotypes were determined with taqman assays. Primary endpoint of the study was the occurrence of adverse events. Secondary endpoints were the occurrence of hot flushes, arthralgia, and myalgia. Results: 807 patients were included in the analyses and genotypes were obtained in 722 cases. One SNP, rs8031311, was associated with a higher incidence of adverse events with an odds ratio of 2.8. Four SNP's were associated with an increased incidence of hot flushes: rs934635, rs4775928, rs16964189, rs6493496 with odds ratio’s of 2.9, 1.8, 1.8 and 2.6 respectively. No association was found between variation in CYP19A1 and the occurrence of arthralgia or myalgia. Conclusions: Germline variation in the CYP19A1 gene is related to the occurrence of adverse events, specifically hot flushes, in early breast cancer patients treated with exemestane. These findings may contribute to the individualization of hormonal therapy in breast cancer. [Table: see text]

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Treatment of Hot Flushes in Breast Cancer Patients with Acupuncture

Acupuncture in Medicine ◽

10.1136/aim.18.1.22 ◽

2000 ◽

Vol 18 (1) ◽

pp. 22-27 ◽

Cited By ~ 19

Author(s):

Emad Tukmachi

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hormone Replacement ◽

Hot Flushes ◽

Breast Cancer Patients ◽

End Of Treatment ◽

Suitable Treatment ◽

Body Acupuncture ◽

Hormone Sensitive ◽

Post Menopausal

A common treatment for post-menopausal hot flushes is to raise oestrogen levels with hormone replacement therapy. However this option is not considered suitable for breast cancer patients with hormone sensitive carcinoma, since an increase in oestrogen is contraindicated. This leaves little available as an effective conventional therapy. There has been some evidence that acupuncture is a suitable treatment for hot flushes, so a series of 22 consecutive breast cancer patients referred by an oncologist for treatment of hot flushes were given a course of classical body acupuncture with two 20–30min treatment sessions per week for up to 7 weeks. The frequency of recorded hot flushes (both day and night) had improved significantly (p<0.001) by the end of treatment. All patients claimed some benefit and 82% had effective relief.

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Management of Early Menopause/Premature Ovarian Insufficiency in Women with or at High Risk of Breast Cancer

Seminars in Reproductive Medicine ◽

10.1055/s-0041-1726467 ◽

2021 ◽

Author(s):

Annabelle Brennan ◽

Martha Hickey

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Survival Rates ◽

Well Being ◽

Menopausal Symptoms ◽

Vasomotor Symptoms ◽

Hot Flushes ◽

Breast Cancer Patients ◽

Night Sweats ◽

Breast Malignancies

AbstractThe global incidence of breast cancer is increasing, as is the efficacy of treatments. Consequently, increasing survival rates reinforce the importance of survivorship issues, including posttreatment menopausal symptoms, sexual function, and mental health and well-being. Breast cancer patients can experience a range of menopausal symptoms associated with their treatment. Most commonly women may experience vasomotor symptoms, including hot flushes and night sweats. Particularly for women on maintenance tamoxifen therapy, up to 80% will experience hot flushes, with almost one-third of these women reporting severe symptoms. Breast cancer patients may also experience genitourinary symptoms of menopause, which may include vaginal dryness and irritation, dyspareunia, and dysuria. Hormonal therapy has long been established as the most effective treatment for vasomotor symptoms. However, the hormonal nature of breast malignancies renders systemic hormone therapies unsuitable for these patients, posing a unique treatment challenge, which may result in clinicians not feeling confident to manage them. Consequently, this review outlines pharmacological and nonpharmacological options for women with bothersome menopausal symptoms after breast cancer treatment and provides practical, evidence-based guidance for clinicians.

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