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

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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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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Update on adjuvant hormonal treatment of early breast cancer

Advances in Therapy ◽

10.1007/s12325-011-0017-1 ◽

2011 ◽

Vol 28 (S6) ◽

pp. 1-18 ◽

Cited By ~ 5

Author(s):

Juan Lao Romera ◽

Teresa de Jesús Puertolas Hernández ◽

Ignacio Peláez Fernández ◽

Teresa Sampedro Gimeno ◽

Roberto Fernández Martínez ◽

...

Keyword(s):

Breast Cancer ◽

Early Breast Cancer ◽

Hormonal Treatment ◽

Adjuvant Hormonal Treatment

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Initialization of adjuvant hormonal treatment for breast cancer

Advances in Therapy ◽

10.1007/s12325-011-0039-8 ◽

2011 ◽

Vol 28 (S6) ◽

pp. 66-84 ◽

Cited By ~ 4

Author(s):

Antonia Martínez Guisado ◽

Alfonso Sánchez Muñoz ◽

María de la Cabeza Lomas Garrido ◽

Manuel Ruíz Borrego ◽

Juan Bayo Calero ◽

...

Keyword(s):

Breast Cancer ◽

Hormonal Treatment ◽

Adjuvant Hormonal Treatment

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Symptoms of hormonal therapy and social support: Is there a connection? Comparison of symptom severity, symptom interference and social support among breast cancer patients receiving and not receiving adjuvant hormonal treatment

European Journal of Oncology Nursing ◽

10.1016/j.ejon.2014.11.003 ◽

2015 ◽

Vol 19 (3) ◽

pp. 260-267 ◽

Cited By ~ 6

Author(s):

Lea Ochayon ◽

Rina Tunin ◽

Aviva Yoselis ◽

Ilana Kadmon

Keyword(s):

Breast Cancer ◽

Social Support ◽

Cancer Patients ◽

Hormonal Therapy ◽

Symptom Severity ◽

Hormonal Treatment ◽

Breast Cancer Patients ◽

Adjuvant Hormonal Treatment

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Using miR-125b in the Prediction of Aromatase Inhibitors Resistance in Metastatic Breast Cancer

Journal of Cancer and Tumor International ◽

10.9734/jcti/2020/v10i330127 ◽

2020 ◽

pp. 1-9

Author(s):

Ashraf Zedain ◽

Hosney Badrway ◽

Ahmed Refaat ◽

Dina Ismail Abd El Razik ◽

Ahmed Mahran ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Aromatase Inhibitors ◽

Metastatic Breast ◽

Hormonal Treatment ◽

Large Sample Size ◽

First Line ◽

Significant Difference ◽

Multiple Metastases ◽

Adjuvant Hormonal Treatment

Background: Several studies investigated the miRNAs in cancer trying to assess the prognosis or to predict the response to certain treatment .One of these miRNAs are miR 125b , it was suggested by previous results as a good marker for prediction of aromatase inhibitors (AI) response. So, this study was conducted to assess the value using miRNA125b as a predictive factor to AI response. Patients and Methods: A total of 90 patients of postmenopausal HR+ve metastatic breast cancer who attended to medical oncology department outpatient’s clinic in SECI, Assiut university Egypt, from May 2017 to September 2018. Patients presented with metastasis at diagnosis as well as patients who relapsed only after 3 years of adjuvant hormonal treatment with SERM were included. All patients received AI as first line treatment for metastatic, miRNA 125b was isolated from peripheral blood samples and measured by using (q PCR).The response of patients was assessed by RECIST criteria and correlated with its expression levels. Results: Expression of the miR125-b was significantly higher in patients than control p= 0.000. However, no significant difference in its expression between those with single of multiple metastases or even between the site of metastases. We didn’t find also any significant difference in response p=0.648 and survival either PFS p=0.406 or OS p=0.384 between those patients with high expression vs. low expression. Conclusion: Our results suggest that miR125b could be used as a diagnostic marker as it is significantly increased in patients than control. However, we don’t recommend using miR125b as a marker to predict the AI resistance as further studies with large sample size are needed to confirm these results.

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