Extended adjuvant hormonal therapy with exemestane has no detrimental effect on the lipid profile of postmenopausal breast cancer patients: final results of the ATENA lipid substudy

e12051 Background: Adjuvant hormonal therapy has been consistently proven to improve multiple outcomes in early breast cancer. Nonetheless, data on rates of adherence and persistence with therapy outside West Europe and North America are scarce. We assessed the adherence and persistence with adjuvant hormonal in a retrospective population based cohort of breast cancer survivors in Maccabi Health Services (MHS), Israel. Methods: We identified women who were diagnosed with breast cancer and initiated adjuvant hormonal therapy between January 2000 and November 2008. Subjects were followed retrospectively from first dispensed tamoxifen or aromatase inhibitor (AI) and up to the earliest of the following events: disease recurrence (indicated by surgery, radiotherapy, chemotherapy or other related therapies), leaving MHS, death, or completion of 5 years of treatment. Discontinuation of therapy was defined as a 180-day or longer treatment gap. Adherence with therapy was assessed using proportion of days covered (PDC) during follow-up period. Survival analysis was used to determine the effect of adherence on all-cause mortality. Results: A total of 4178 women with breast cancer were followed for a median 7.8 years. Over 90% of patients received tamoxifen as the initial hormonal agent. Mean PDC was 84% with lower rates associated with younger age, smoking status, comorbidities and year of diagnosis. Residential area did not affect adherence. Differences were not found. Discontinuation of therapy occurred in 23% of study patients. Among persistent patients, 70% were optimally adherent with therapy (PDC>=80%). Association between adherence with therapy and survival is investigated. Conclusions: Adherence to adjuvant hormonal therapy among Israeli breast cancer patients with national health insurance is high in comparison to international reports. Nevertheless, suboptimal adherence was identified among younger (<45y) patients. Because of the efficacy of hormonal therapy in preventing recurrence and death in women with early-stage breast cancer, interventions are necessary to identify and prevent suboptimal adherence among high risk subgroups.

Download Full-text

Assessment of cardiotoxicity in hormone positive postmenopausal breast cancer patients receiving aromatase inhibitors

Journal of Solid Tumors ◽

10.5430/jst.v9n1p11 ◽

2019 ◽

Vol 9 (1) ◽

pp. 11

Author(s):

Reham M. Faheim ◽

Eman A. El-Shaarawy ◽

Dina A. Salem ◽

Rehab G. Shaaban

Keyword(s):

Breast Cancer ◽

Blood Pressure ◽

Lipid Profile ◽

Cancer Patients ◽

Aromatase Inhibitors ◽

Hormone Receptor ◽

Postmenopausal Breast Cancer ◽

P Value ◽

Breast Cancer Patients ◽

Hormone Receptor Positive

Background: Aromatase inhibitors (AIs) represent an effective endocrine treatment for hormone receptor-positive postmenopausal breast cancer patients with early stage or metastatic disease.Objective: Assessment of Cardiotoxicity in Hormone positive Postmenopausal Breast Cancer Patients receiving AIs (upfront orswitch therapy).Methods: This cross sectional study included 123 postmenopausal breast cancer patients presented to the Clinical Oncology Department, Ain Shams University (Cairo, Egypt) in the interval from August 2016 to June 2017 with hormone receptor positive receiving Aromatase Inhibitors, To assess cardiotoxicity in these patients, they were subjected to blood pressure and lipid profile measurement, electrocardiography (ECG), and electrocardiography (ECHO) and classified into patients had Nolvadex then A.I (arm 1) and others had upfront A.I (arm 2).Results: The age of patients ranged from 41 years to 85 years with mean age of 61 years. Seventy one patients (57.7%) showed cardiotoxicity as assessed by ECHO. They showed significant correlation with rising age above 62 years, IHD, history of HTN and DM (p value: .001, .001, .017 and 0.035 respectively). However, correlation between cardiotoxity and blood pressure changes, lipid profile changes and ECG findings and ECHO changes in switch therapy and upfront A.I were not statistically significant (p value = .275, .116, .081 and .761 respectively).Conclusion: Assessment of cardiotoxicity in hormone positive postmenopausal breast cancer patients receiving Aromatase Inhibitors showed evidence of cardiotoxicity in half the patients (57.7%) as detected by ECHO only. They showed statistically non significant correlations either recievied switch therapy or upfront A.I.

Download Full-text

Is there is an economic value for sequential Hormonal therapy for postmenopausal breast cancer patients?

European Journal of Cancer ◽

10.1016/s0959-8049(18)30530-6 ◽

2018 ◽

Vol 92 ◽

pp. S101

Author(s):

A. Abou Taleb

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hormonal Therapy ◽

Economic Value ◽

Postmenopausal Breast Cancer ◽

Breast Cancer Patients

Download Full-text

111 Hormonal Therapy and Lipid Profile in Breast Cancer Patients

European Journal of Oncology Nursing ◽

10.1016/s1462-3889(12)70123-0 ◽

2012 ◽

Vol 16 ◽

pp. S40

Author(s):

D. Chen ◽

C.H.E. Lin ◽

S.J. Kuo

Keyword(s):

Breast Cancer ◽

Lipid Profile ◽

Cancer Patients ◽

Hormonal Therapy ◽

Breast Cancer Patients

Download Full-text

Practical consensus recommendations on duration of adjuvant hormonal therapy in breast cancer

South Asian Journal of Cancer ◽

10.4103/sajc.sajc_122_18 ◽

2018 ◽

Vol 07 (02) ◽

pp. 142-145 ◽

Cited By ~ 1

Author(s):

S. Gupta ◽

M. Singh ◽

Amish Vora ◽

G. Babu ◽

M. Walia ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hormonal Therapy ◽

Hormone Receptor ◽

Early Stage ◽

Adjuvant Hormonal Therapy ◽

Breast Cancer Patients ◽

Term Survival ◽

Consensus Recommendations ◽

Hormone Receptor Positive

AbstractOptimization of adjuvant systemic therapy in women with early-stage hormone receptor-positive breast cancer includes the consideration of chemotherapy and duration of hormone therapy. Adjuvant hormonal therapy significantly improves long-term survival of breast cancer patients with hormone receptor-positive disease. Despite the proven clinical efficacy of tamoxifen and aromatase inhibitors, many breast cancer survivors either fail to take the correct dosage at the prescribed frequency (adherence) or discontinue therapy (persistence). Expert oncologist discussed on the duration of adjuvant hormonal therapy for improvement of OS and quality of life of breast cancer patients by providing reduction in recurrence and mortality. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.

Download Full-text