Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy

Cella, David; Fallowfield, Lesley J.

doi:10.1007/s10549-007-9548-1

Cited by 286Breast Cancer Treatment StudiesCancer survivorship and careMenopause: Health Impacts and Treatments

Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy

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Cella, David, Fallowfield, Lesley J.·2008·Breast Cancer Research and Treatment

DOI 10.1007/s10549-007-9548-1

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Abstract

In postmenopausal women with hormone receptor-positive early-stage breast cancer, the use of aromatase inhibitors (AIs) to suppress estrogen is associated with improved clinical outcomes compared with tamoxifen therapy. Women receiving such endocrine therapy may experience treatment-related side effects that negatively affect health-related quality of life (QoL) and adherence to therapy. In published clinical trials and in clinical practice, adverse events (AEs) constitute the main reason for nonadherence to endocrine treatment. Serious AEs are sometimes resolved by switching to a different agent, whereas other side effects can often be managed to allow patients to remain on therapy without sacrificing QoL. Across all adjuvant endocrine trials, regardless of the treatment received, vasomotor symptoms such as hot flashes are the most common side effects. Other frequently reported side effects, such as vaginal discharge, vaginal dryness, dyspareunia, and arthralgia, vary in prevalence between tamoxifen and AIs. Here we provide an overview of reported AEs of adjuvant endocrine therapy, focusing on those that are amenable to pharmacologic or nonpharmacologic management without treatment discontinuation. Also highlighted are specific management strategies that may improve patient QoL and thereby optimize adherence to therapy, which in turn might improve patient outcomes.

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Hot flushes and night sweats can compromise quality of life.
“and can compromise quality of life [17, 18].”
From Acceptance and Commitment Therapy to support medication decision-making and quality of life in women with breast cancer: protocol for a pilot randomised controlled trial (2022) · cites this paper as [17]
An observational linguistic study found that doctors tend to give monologues with general information about adjuvant hormonal therapy and do not spend enough time discussing potential barriers and treatment impact with patients.
“An observational linguistic study that analyzed doctor-patient communication around adjuvant hormonal therapy found that doctors tend to do monologues providing general information about adjuvant hormonal therapy, but do not spend enough time discussing with the patient about potential barriers and how the treatment may particularly impact them.41”
From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [41]

1 retracted

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Retracted
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BackgroundMethodInfluential
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Result
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Zoledronic acid is superior to pamidronate for the treatment of bone metastases in breast carcinoma patients with at least one osteolytic lesion
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BackgroundSelf-citation
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Background
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BackgroundSelf-citation
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BackgroundMethod
Does hormone therapy for the treatment of breast cancer have a detrimental effect on memory and cognition? A pilot study
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BackgroundSelf-citation
A pilot trial assessing the efficacy of paroxetine hydrochloride (Paxil) in controlling hot flashes in breast cancer survivors.
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BackgroundResult
The influence of letrozole on serum lipid concentrations in postmenopausal women with primary breast cancer who have completed 5 years of adjuvant tamoxifen (NCIC CTG MA.17L)
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“17 trial (with placebo as the comparator) [3, 18].”
Background
Quality of Life in the Intergroup Exemestane Study: A Randomized Trial of Exemestane Versus Continued Tamoxifen After 2 to 3 Years of Tamoxifen in Postmenopausal Women With Primary Breast Cancer
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“Dyspareunia and diminished libido were also reported in the IES, but without a significant difference in incidence between the AI and tamoxifen groups [24].”
BackgroundInfluentialSelf-citation
Patients' preference for administration of endocrine treatments by injection or tablets: results from a study of women with breast cancer
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“Although 63% of women preferred daily oral medication over a monthly intramuscular (im) injection, the primary reason given for the im preference was to ensure adherence [14].”
BackgroundSelf-citation
Pre‐treatment factors related to cognitive functioning in women newly diagnosed with breast cancer
Cimprich, B., So, H., Ronis, D. L., & Trask, C. L. (2004) · Psycho-Oncology · doi:10.1002/pon.821 · Cited by 172 · cited 2× · see citing works
“A chronic health problem and menopausal status are secondary predictors [79].”
Background
Breast Cancer Chemotherapy-Related Cognitive Dysfunction
Ahles, T. A., & Saykin, A. J. (2002) · Clinical Breast Cancer · doi:10.3816/cbc.2002.s.018 · Cited by 171 · cited 1× · see citing works
“In retrospective studies of breast cancer survivors, some investigators found cognitive decline (especially in verbal learning, visuospatial functioning, and visual memory) to be greater in patients who received tamoxifen plus chemotherapy (compared with chemotherapy alone or surgery alone), while others reported that…”
Background
Aromatase inhibitors and the syndrome of arthralgias with estrogen deprivation
Felson, D. T., & Cummings, S. R. (2005) · Arthritis & Rheumatism · doi:10.1002/art.21364 · Cited by 163 · cited 2× · see citing works
“Increased pain sensitivity due to estrogen deficiency might also be a factor in arthralgia, as estrogen is known to modulate neural processing of nociceptive input at the level of the central nervous system [46].”
Background
The clinical significance of quality of life assessments in oncology: a summary for clinicians
Sloan, J. A., Frost, M. H., Berzon, R., Dueck, A., Guyatt, G., Moinpour, C., Sprangers, M., Ferrans, C., Cella, D., & Clinical Significance Consensus Meeting Group (2006) · Supportive Care in Cancer · doi:10.1007/s00520-006-0085-y · Cited by 149 · cited 1× · see citing works
“In addition to clinician-reported AEs recorded for safety monitoring in clinical trials, data captured via patient selfreport on validated QoL instruments may provide important complementary information about a drug’s tolerability [19].”
Self-citation
ATAC trial update
Mastro, L. D., & Venturini, M. (2005) · The Lancet · doi:10.1016/s0140-6736(05)74802-9 · Cited by 133 · see citing works
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Formenti, S. C., Volm, M. D., Skinner, K. A., SPICER, D. V., Cohen, D., Perez, E. A., Bettini, A., Groshen, S. G., Gee, C., Florentine, B. D., et al. (2003) · Journal of Clinical Oncology · doi:10.1200/jco.2003.06.132 · Cited by 127 · see citing works
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“As shown in Table 1, these trials have explored the use of AIs as initial adjuvant treatment compared with tamoxifen [1–3], as sequential therapy following 2–3 years of tamoxifen [4–6], and as extended therapy following 5 years of tamoxifen [7, 8].”
MethodInfluential
Phase III Comparison of Depomedroxyprogesterone Acetate to Venlafaxine for Managing Hot Flashes: North Central Cancer Treatment Group Trial N99C7
Loprinzi, C. L., Levitt, R., Barton, D. L., Sloan, J. A., Dakhil, S. R., Nikcevich, D. A., Bearden, J. D., Mailliard, J. A., Tschetter, L. K., Fitch, T. R., et al. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2005.04.7324 · Cited by 119 · cited 1× · see citing works
“acupuncture have shown efficacy in reducing hot flashes [50, 51, 57, 61].”
Background
Nodal Metastasis Is Highly Consistent in Squamous Cell Carcinoma of the Vulva
Penson, R. T., Fuller, A. F., de Hullu, J. A., & van der Zee, A. G. J. (2001) · Journal of Clinical Oncology · doi:10.1200/jco.2001.19.10.2767 · Cited by 118 · see citing works
Feasibility of Quantifying the Effects of Epoetin Alfa Therapy on Cognitive Function in Women with Breast Cancer Undergoing Adjuvant or Neoadjuvant Chemotherapy
O’Shaughnessy, J., Vukelja, S. J., Holmes, F. A., Savin, M. A., Jones, M., Royall, D. R., George, M. J., & Hoff, D. D. V. (2005) · Clinical Breast Cancer · doi:10.3816/cbc.2005.n.002 · Cited by 114 · cited 1× · see citing works
“Patients randomized to epoetin alfa, compared with placebo, exhibited higher mean hemoglobin levels, better executive control function, and less fatigue at 12 weeks of adjuvant anthracycline-based chemotherapy, though group differences were not significant at 6 months [83].”
Background
Tolerability of hormone therapies for breast cancer: How informative are documented symptom profiles in medical notes for ‘well-tolerated’ treatments?
Fellowes, D., Fallowfield, L. J., Saunders, C. M., & Houghton, J. (2001) · Breast Cancer Research and Treatment · doi:10.1023/a:1010684903199 · Cited by 100 · cited 1× · see citing works
“In one assessment, treatment-related symptoms documented by clinicians in medical notes were compared to those that patients reported in an interview, and it was found that only 89% of women receiving hormonal therapy had side effects in their medical notes, compared with 99% who reported side effects in an interview…”
ResultSelf-citation
Switching to anastrozole (ANA) vs continued tamoxifen (TAM) treatment of early breast cancer (EBC). Updated results of the Italian tamoxifen anastrozole (ITA) trial
Boccardo, F., RUBAGOTTI, A., Puntoni, M., Guglielmini, P., Porpiglia, M., Mesiti, M., Rinaldini, M., Paladini, G., Distante, V., & Franchi, R. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.23.16_suppl.526 · Cited by 100 · see citing works
Intramuscular depot medroxyprogesterone versus oral megestrol for the control of postmenopausal hot flashes in breast cancer patients: a randomized study
Bertelli, G., Venturini, M., Mastro, L. D., Bergaglio, M., Sismondi, P., Biglia, N., Venturini, S., Porcile, G., Pronzato, P., Costantini, M., et al. (2002) · Annals of Oncology · doi:10.1093/annonc/mdf151 · Cited by 98 · cited 3× · see citing works
“acupuncture have shown efficacy in reducing hot flashes [50, 51, 57, 61].”
Background
The Effects of Tamoxifen and Estrogen on Brain Metabolism in Elderly Women
Ernst, T. (2002) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/94.8.592 · Cited by 93 · see citing works
Pilot evaluation of citalopram for the relief of hot flashes.
Barton, D. L., Loprinzi, C. L., Novotny, P., Shanafelt, T. D., Sloan, J. A., Wahner‐Roedler, D. L., Rummans, T. A., Christensen, B. J., Dakhil, S. R., & Martin, L. (2003) · PubMed · Cited by 91 · see citing works
Acupuncture and Self Acupuncture for Long Term Treatment of Vasomotor Symptoms in Cancer Patients - Audit and Treatment Algorithm
Filshie, J., Bolton, T., Browne, D. R. G., & Ashley, S. E. (2005) · Acupuncture in Medicine · doi:10.1136/aim.23.4.171 · Cited by 87 · see citing works
Effects of third-generation aromatase inhibitors on bone
McCloskey, E. V. (2006) · European Journal of Cancer · doi:10.1016/j.ejca.2005.10.028 · Cited by 78 · cited 1× · see citing works
“Arthralgia is considered a class effect of AIs, with a reported incidence 2–8% higher in patients treated with AIs versus those treated with tamoxifen [44, 45].”
Background
Hot flushes in breast cancer patients
Mom, C. H., Buijs, C., Willemse, P. H. B., Mourits, M. J. E., & de Vries, E. G. E. (2005) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2005.04.009 · Cited by 68 · cited 3× · see citing works
“Norepinephrine and serotonin are the primary neurotransmitters involved in thermoregulation [48].”
BackgroundInfluential
Inhibition of RANKL as a treatment for osteoporosis: Preclinical and early clinical studies
McClung, M. R. (2006) · Current Osteoporosis Reports · doi:10.1007/s11914-006-0012-7 · Cited by 62 · cited 1× · see citing works
“New targeted therapies that inhibit bone loss (such as Fc-osteoprotegerin fusion protein and human anti-receptor activator of NF Kappa B ligand [RANKL] antibody) are still in preliminary clinical studies [38, 39].”
Background
An open-label, fixed-dose study of bupropion effect on sexual function scores in women treated for breast cancer
Mathias, C., Mendes, C. M. C., de Sena, E. P., de Moraes, E. D., Bastos, C., Braghiroli, M. I., Nuñez, G., Athanazio, R. A., Albán, L. F., Moore, H. C. F., et al. (2006) · Annals of Oncology · doi:10.1093/annonc/mdl304 · Cited by 62 · see citing works
Management of Cancer-Treatment–Induced Bone Loss in Postmenopausal Women Undergoing Adjuvant Breast Cancer Therapy: A Z-FAST Update
Brufsky, A. (2006) · Seminars in Oncology · doi:10.1053/j.seminoncol.2006.03.022 · Cited by 59 · cited 13× · see citing works
“In a study of women with EBC who discontinued tamoxifen because of severe side effects, switching to anastrozole improved ES scores and patient QoL [23].”
BackgroundResultInfluential
Non-adherence to endocrine therapy for breast cancer
Partridge, A. H. (2006) · Annals of Oncology · doi:10.1093/annonc/mdj141 · Cited by 55 · cited 1× · see citing works
“Nonadherence, a relatively new focus of research interest in breast cancer, is a major contributing factor to variability in a drug’s intended therapeutic effect [12].”
Background
Cerebral Venous Thrombosis Associated With Epoetin Alfa Therapy
Finelli, P. F., & Carley, M. D. (2000) · Archives of Neurology · doi:10.1001/archneur.57.2.260 · Cited by 52 · cited 1× · see citing works
“Venous thromboembolism is a risk of erythropoietic therapy in the presence of elevated hemoglobin values [84].”
Background
Chemotherapy-Induced Cognitive Impairment in Women With Breast Cancer: A Critique of the Literature
Jansen, C. E., Miaskowski, C. A., Dodd, M., & Dowling, G. A. (2005) · Oncology nursing forum · doi:10.1188/05.onf.329-342 · Cited by 40 · cited 1× · see citing works
“, surgery or radiation), impairment has been variably reported in speed of information processing, motor function, visual memory, language, attention and concentration, executive function, verbal memory, and visuospatial skill [70].”
Background
Vascular effects of aromatase inhibitors: Data from clinical trials
Howell, A., & Cuzick, J. M. (2005) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2005.04.005 · Cited by 39 · cited 1× · see citing works
“Several large prevention studies are currently recruiting women at high risk of developing breast cancer to be randomized to anastrozole or placebo (The International Breast Cancer Intervention Study II [IBIS II]) or to exemestane or placebo (MAP3) [80].”
Background
Managing Patients on Endocrine Therapy: Focus on Quality-of-Life Issues
Whelan, T. J., & Pritchard, K. I. (2006) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-05-2185 · Cited by 39 · cited 2× · see citing works
“17 trial of letrozole as extended adjuvant therapy following 5 years of tamoxifen, without seeming to interfere with observed efficacy [11, 62].”
Background
Quality of life and clinical decisions in chemotherapy-induced anemia.
Cella, D. F. (2006) · PubMed · Cited by 30 · see citing works
Self-citation
Choosing between an aromatase inhibitor and tamoxifen in the adjuvant setting
Morales, L., Neven, P., & Paridaens, R. (2005) · Current Opinion in Oncology · doi:10.1097/01.cco.0000180434.31991.bf · Cited by 29 · cited 1× · see citing works
“Although tamoxifen reportedly elicits uterine abnormalities (endometrial cysts and polyps, enlargement of pre-existing fibroids) from as early as 3 months of therapy, AIs induce uterine atrophy and may even decrease uterine abnormalities due to a preceding course of tamoxifen [30].”
Background
Five-year quality of life (QOL) follow-up of adjuvant endocrine therapy for postmenopausal women in the Arimidex (A), Tamoxifen (T), Alone or in Combination (ATAC) Trial
Cella, D. F., & Fallowfield, L. J. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.23.16_suppl.577 · Cited by 24 · see citing works
Self-citation
Assessing the quality of life of postmenopausal women randomized into the ATAC (“arimidex”, tamoxifen, alone or in combination) adjuvant breast cancer trial
Fallowfield, L. J., & Cella, D. F. (2003) · The Breast · doi:10.1016/s0960-9776(03)80136-4 · Cited by 24 · see citing works
Self-citation
Dehydroepiandrosterone for the Treatment of Hot Flashes: A Pilot Study
Barton, D. L., Loprinzi, C. L., Atherton, P. J., Kottschade, L. A., Collins, M., Carpenter, P. C., Adjei, A. A., Rummans, T. A., Shanafelt, T. D., Christensen, B., et al. (2006) · Supportive Cancer Therapy · doi:10.3816/sct.2006.n.004 · Cited by 23 · cited 3× · see citing works
“In a small pilot study, DHEA reduced hot flashes by approximately 50% after 5 weeks of treatment in postmenopausal women with a history of breast cancer [51].”
Background
Erythropoietin as a critical component of breast cancer therapy: survival, synergistic, and cognitive applications
Leyland-Jones, B. R. (2003) · Seminars in Oncology · doi:10.1053/j.seminoncol.2003.08.020 · Cited by 20 · cited 1× · see citing works
“Reports that epoetin alfa has beneficial effects on QoL and cognitive function are consistent with the detection of erythropoietin and its receptor in the central nervous system [82].”
Background
Osteoprotegerin as a potential therapy for osteoporosis
Hamdy, N. A. T. (2006) · Current Rheumatology Reports · doi:10.1007/s11926-006-0026-2 · Cited by 16 · see citing works
Osteoprotegerin as a potential therapy for osteoporosis
Hamdy, N. A. T. (2005) · Current Osteoporosis Reports · doi:10.1007/s11914-996-0014-5 · Cited by 15 · see citing works
Estrogen, Tamoxifen, and the Brain
Ganz, P. A. (2002) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/94.8.547 · Cited by 14 · cited 1× · see citing works
“123 breast cancer survivors [77, 78 ]. From the vantage point of a prospective, longitudinal study, EBC patients receiving one or more nonchemotherapy adjuvant treatments (endocrine, radiotherapy, trastuzumab) experienced significant cognitive decline from baseline (primarily in memory and concentration) in 26% and 14…”
Background
Atraumatic Joint and Limb Pain in the Elderly
Harrington, L. L., & Schneider, J. I. (2006) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2006.01.004 · Cited by 11 · see citing works
Aromatase Inhibitor Agents in Breast Cancer: Evolving Practices in Hormonal Therapy Treatment
Viale, P. H. (2005) · Oncology nursing forum · doi:10.1188/05.onf.343-353 · Cited by 9 · cited 1× · see citing works
“Among the pharmacologic options for minimizing bone loss in those receiving adjuvant endocrine therapy for EBC, supplementation with calcium and vitamin D is widely recommended, though not yet adequately studied [32].”
Background
Five-Year Update of an Expanded Phase II Study of Dose-Dense and -Intense Doxorubicin, Paclitaxel and Cyclophosphamide (ATC) in High-Risk Breast Cancer
Abu-Khalaf, M. M., Windsor, S., Ebisu, K., Salikooti, S., Ananthanarayanan, G., Chung, G. G., DiGiovanna, M. P., Haffty, B. G., Abrams, M., Farber, L. R., et al. (2005) · Oncology · doi:10.1159/000089991 · Cited by 9 · see citing works
Under-reporting of symptoms in patients with early breast cancer (EBC) who have received tamoxifen treatment for 2–3 years (abstract 48)
Coombes, R. C., Bliss, J. M., Hall, E., Gibson, L., Fallowfield, L. J., & Massimini, G. (2003) · Cited by 8 · see citing works
Self-citation
Tamoxifen-related endocrine symptoms in early breast cancer patients are relieved when it is switched to anastrozole
Massacesi, C., Zepponi, L., Rocchi, M., Rossini, S., & Burattini, L. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2006.24.18_suppl.10597 · Cited by 3 · cited 1× · see citing works
“In a study of women with EBC who discontinued tamoxifen because of severe side effects, switching to anastrozole improved ES scores and patient QoL [23].”
Background
Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer. Results of the ATAC (Arimidex, Tamoxifen Alone or in Combination) trial efficacy and safety update analyses
Dowsett, M. (2003) · Cited by 2 · see citing works

Flagged first, then by citations

Sorted by citations

Health-related quality of life in breast cancer patients: A bibliographic review of the literature from 1974 to 2007
Montazeri, A. (2008) · Journal of Experimental & Clinical Cancer Research · doi:10.1186/1756-9966-27-32 · Cited by 773 · see citing works
Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review
Murphy, C. C., Bartholomew, L. K., Carpentier, M. Y., Bluethmann, S. M., & Vernon, S. W. (2012) · Breast Cancer Research and Treatment · doi:10.1007/s10549-012-2114-5 · Cited by 708 · see citing works
Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018
Mokhtari-Hesari, P., & Montazeri, A. (2020) · Health and Quality of Life Outcomes · doi:10.1186/s12955-020-01591-x · Cited by 462 · see citing works
Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): a randomised controlled trial
Mann, E., Smith, M. J., Hellier, J., Balabanovic, J. A., Hamed, H., Grunfeld, E. A., & Hunter, M. S. (2012) · The Lancet Oncology · doi:10.1016/s1470-2045(11)70364-3 · Cited by 307 · see citing works
A Randomized Trial to Increase Physical Activity in Breast Cancer Survivors
Rogers, L. Q., Hopkins-Price, P. L., Vicari, S., Pamenter, R. W., Courneya, K. S., Markwell, S. J., Verhulst, S. J., Hoelzer, K. L., Naritoku, C., Jones, L., et al. (2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31818e0e1b · Cited by 220 · see citing works
Vasomotor Symptoms Across the Menopause Transition
Avis, N. E., Crawford, S. L., & Green, R. (2018) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2018.07.005 · Cited by 216 · see citing works
Relationship Between Deficits in Overall Quality of Life and Non–Small-Cell Lung Cancer Survival
Sloan, J. A., Zhao, X., Novotny, P. J., Wampfler, J. A., Garces, Y. I., Clark, M. M., & Yang, P. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2010.33.4631 · Cited by 183 · see citing works
“Perhaps, given their poor functioning, individuals with poor QOL demonstrate poor adherence to their medical treatment.(58,59) If a patient with lung cancer is not feeling well, optimistic, or motivated, it would seem possible that he or she may be less likely to keep medical appointments, attend treatment sessions, o…”
Background
Long‐term psychological benefits of cognitive‐behavioral stress management for women with breast cancer: 11‐year follow‐up of a randomized controlled trial
Stagl, J. M., Bouchard, L. C., Lechner, S. C., Blomberg, B. B., Gudenkauf, L. M., Jutagir, D. R., Glück, S., Derhagopian, R. P., Carver, C. S., & Antoni, M. H. (2015) · Cancer · doi:10.1002/cncr.29076 · Cited by 174 · see citing works
Non-hormonal interventions for hot flushes in women with a history of breast cancer
Gabriel Rada, G., Daniel Capurro, N., Tomás Pantoja, C., Corbalán, J., Moreno, G., Luz María Letelier, S., & Vera, C. M. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004923.pub2 · Cited by 162 · see citing works
Breast cancer in young women and its impact on reproductive function
Hickey, M., Peate, M., Saunders, C., & Friedlander, M. (2009) · Human Reproduction Update · doi:10.1093/humupd/dmn064 · Cited by 180 · see citing works
“Observational studies suggest that BRCA1 mutation carriers who have their first child at 30 years or older may have a reduced personal risk of breast cancer [43].”
Prospective Study to Assess Short-Term Intra-Articular and Tenosynovial Changes in the Aromatase Inhibitor–Associated Arthralgia Syndrome
Morales, L., Pans, S., Verschueren, K., CALSTER, B. V., Paridaens, R., Westhovens, R., Timmerman, D., SMET, L. D., Vergote, I. B., Christiaens, M.-R., et al. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.15.4005 · Cited by 150 · see citing works
Simple Strategies for Vaginal Health Promotion in Cancer Survivors
Carter, J., Goldfrank, D. J., & Schover, L. R. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01988.x · Cited by 138 · see citing works
The Physical Consequences of Gynecologic Cancer Surgery and Their Impact on Sexual, Emotional, and Quality of Life Issues
Carter, J., Stabile, C., Gunn, A., & Sonoda, Y. (2013) · The Journal of Sexual Medicine · doi:10.1111/jsm.12002 · Cited by 130 · see citing works
Physical Activity and Health Outcomes Three Months After Completing a Physical Activity Behavior Change Intervention: Persistent and Delayed Effects
Rogers, L. Q., Hopkins-Price, P. L., Vicari, S., Markwell, S. J., Pamenter, R. W., Courneya, K. S., Hoelzer, K. L., Naritoku, C., Edson, B., Jones, L., et al. (2009) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-08-1045 · Cited by 127 · see citing works
“Because of the association between adjuvant endocrine therapy and arthralgias (37) and the intervention focus on increasing weight bearing exercise (i.”
BackgroundResultInfluential
Patient-reported factors associated with adherence to adjuvant endocrine therapy after breast cancer: an integrative review
Lambert, L. K., Balneaves, L. G., Howard, A. F., & Gotay, C. C. (2017) · Breast Cancer Research and Treatment · doi:10.1007/s10549-017-4561-5 · Cited by 126 · see citing works
“Limited treatment options, however, are available for managing AET-related side effects [68], which challenges clinicians in providing support to women experiencing symptoms.”
Background
Understanding tamoxifen adherence in women with breast cancer: A qualitative study
Moon, Z., Moss‐Morris, R., Hunter, M. S., & Hughes, L. D. (2017) · British Journal of Health Psychology · doi:10.1111/bjhp.12266 · Cited by 112 · see citing works
“Changes to mood and irritability are reported in 11% - 67% of patients taking tamoxifen (Cella & Fallowfield, 2008; Moon et al., 2016).”
Background
Sisters Peer Counseling in Reproductive Issues After Treatment (SPIRIT)
Schover, L. R., Rhodes, M. M., Baum, G. P., Adams, J. H., Jenkins, R., LEWIS, P. E., & Jackson, K. E. (2011) · Cancer · doi:10.1002/cncr.26139 · Cited by 115 · see citing works
“Premenopausal women who experience abrupt, treatment-related, premature ovarian failure have the greatest risk of developing such symptoms,(4,8,9) but women who are treated with aromatase inhibitors also experience severe sexual and menopausal complaints.(10) African American women may be particularly vulnerable to re…”
Background
Practical clinical guidelines for assessing and managing menopausal symptoms after breast cancer
Hickey, M., Saunders, C. M., Partridge, A. H., Santoro, N. F., Joffe, H., & Stearns, V. (2008) · Annals of Oncology · doi:10.1093/annonc/mdn353 · Cited by 112 · see citing works
“These are likely to vary according to age, menopausal status and relationship factors as well as the nature of surgical and endocrine treatments [8].”
Background
Lifestyle Factors in Cancer Survivorship: Where We Are and Where We Are Headed
Vijayvergia, N., & Denlinger, C. S. (2015) · Journal of Personalized Medicine · doi:10.3390/jpm5030243 · Cited by 110 · see citing works
“Though not well studied in cancer survivors, these benefits may be especially relevant in survivors on endocrine therapies that increase risk of osteoporosis [87].”
Background
Association Between Out-Of-Pocket Costs, Race/Ethnicity, and Adjuvant Endocrine Therapy Adherence Among Medicare Patients With Breast Cancer
Farias, A. J., & Du, X. L. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2016.68.2807 · Cited by 108 · see citing works
Hormonal therapy in breast cancer: A model disease for the personalization of cancer care
Puhalla, S., Bhattacharya, S., & Davidson, N. E. (2012) · Molecular Oncology · doi:10.1016/j.molonc.2012.02.003 · Cited by 101 · see citing works
“There are pharmacological and nonpharmacological solutions to these side effects that can alleviate these side effects, such as the use of venlafaxine or gabapentin for hot flashes (Cella and Fallowfield, 2008).”
Background
Factors associated with intentional and unintentional non-adherence to adjuvant endocrine therapy following breast cancer
Brett, J., Fenlon, D., Boulton, M., Hulbert-Williams, N. J., Walter, F. M., Donnelly, P., Lavery, B., Morgan, A., Morris, C., & Watson, E. (2018) · European Journal of Cancer Care · doi:10.1111/ecc.12601 · Cited by 98 · see citing works
“AETs are known to have a significant side effect profile which can adversely affect quality of life and have previously been cited as barriers to continuing with treatment (Harrow et al, 2013; Morgan & Fenlon 2013; Fenlon et al, 2009; Cella & Fallowfield 2008).”
Background
Tamoxifen in men: a review of adverse events
Wibowo, E., Pollock, P. A., Hollis, N., & Wassersug, R. J. (2016) · Andrology · doi:10.1111/andr.12197 · Cited by 97 · see citing works
“Studies in women with breast cancer suggest that informing patients about treatment-related AEs can help adherence to treatment (Heisig et al., 2014) and better management of AEs (Cella & Fallowfield, 2008).”
Background
Management of genitourinary syndrome of menopause in breast cancer survivors: An update
López, D. M. L. (2022) · World Journal of Clinical Oncology · doi:10.5306/wjco.v13.i2.71 · Cited by 99 · see citing works
Vaginal erbium laser as second-generation thermotherapy for the genitourinary syndrome of menopause: a pilot study in breast cancer survivors
Gambacciani, M., & Marco Levancini, A. (2016) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000000761 · Cited by 95 · see citing works
Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue
Lester, J., Pahouja, G., Andersen, B. L., & Lustberg, M. B. (2015) · Journal of Personalized Medicine · doi:10.3390/jpm5020050 · Cited by 93 · see citing works
“The use of chemotherapy during the first year after diagnosis of breast cancer significantly increases the risk of CIOF [7,30–32].”
BackgroundInfluential
Patient-reported predictors of early treatment discontinuation: treatment-related symptoms and health-related quality of life among postmenopausal women with primary breast cancer randomized to anastrozole or exemestane on NCIC Clinical Trials Group (CCTG) MA.27 (E1Z03)
Wagner, L. I., Zhao, F., Goss, P. E., Chapman, J. W., Shepherd, L. E., Whelan, T. J., Mattar, B. I., Bufill, J. A., Schultz, W. C., LaFrancis, I. E., et al. (2018) · Breast Cancer Research and Treatment · doi:10.1007/s10549-018-4713-2 · Cited by 91 · see citing works
“The discrepancy between clinician- and patient-rated treatment side effects has been previously documented with AI therapy-related symptoms [6, 15].”
Self-citation
Aromatase inhibitor therapy: toxicities and management strategies in the treatment of postmenopausal women with hormone-sensitive early breast cancer
Dent, S. F., Gaspo, R., Kissner, M., & Pritchard, K. I. (2011) · Breast Cancer Research and Treatment · doi:10.1007/s10549-011-1351-3 · Cited by 90 · see citing works
Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review
Hurtado-de-Mendoza, A., Cabling, M. L., Lobo, T., Dash, C., & Sheppard, V. B. (2016) · Clinical Breast Cancer · doi:10.1016/j.clbc.2016.03.006 · Cited by 79 · see citing works
Is the toxicity of adjuvant aromatase inhibitor therapy underestimated? Complementary information from patient-reported outcomes (PROs)
Oberguggenberger, A., Michael, H., Sztankay, M. J., Meraner, V., Beer, B., Oberacher, H., Giesinger, J. M., Kemmler, G., Egle, D., Gamper, E., et al. (2011) · Breast Cancer Research and Treatment · doi:10.1007/s10549-011-1378-5 · Cited by 83 · see citing works
Acupuncture improves health-related quality-of-life (HRQoL) and sleep in women with breast cancer and hot flushes
Frisk, J., Källström, A.-C., Wall, N., Fredrikson, M. G., & Hammar, M. L. (2011) · Supportive Care in Cancer · doi:10.1007/s00520-011-1134-8 · Cited by 85 · see citing works
“This is partially due to endocrine therapy like tamoxifen, which may increase hot flushes [11], making patients stop their treatment prematurely [12].”
Background
Predicting Adherence to Tamoxifen for Breast Cancer Adjuvant Therapy and Prevention
Lin, J., Zhang, S. M., & Manson, J. E. (2011) · Cancer Prevention Research · doi:10.1158/1940-6207.capr-11-0380 · Cited by 84 · see citing works
Exercise in Clinical Cancer Care: A Call to Action and Program Development Description
Mina, D. S., Alibhai, S. M. H., Matthew, A., Guglietti, C. L., Steele, J. R., Trachtenberg, J., & Ritvo, P. G. (2012) · Current Oncology · doi:10.3747/co.19.912 · Cited by 81 · see citing works
The impact of age on changes in quality of life among breast cancer survivors treated with breast-conserving surgery and radiotherapy
Bantema-Joppe, E. J., de Bock, G. H., Iersel, M. W.-V., Busz, D. M., Ranchor, A., Langendijk, J. A., Maduro, J. H., & van den Heuvel, E. R. (2015) · British Journal of Cancer · doi:10.1038/bjc.2014.632 · Cited by 80 · see citing works
“The lack of change over time cannot be explained by the use of systemic treatment, resulting in vaginal dryness (Varras et al, 2003; Cella and Fallowfield, 2008) since we controlled for systemic treatment.”
Background
Physical Activity and Breast Cancer: A Qualitative Study on the Barriers to and Facilitators of Exercise Promotion from the Perspective of Health Care Professionals
Smith‐Turchyn, J., Richardson, J. A., Tozer, R. G., McNeely, M. L., & Thabane, L. (2016) · Physiotherapy Canada · doi:10.3138/ptc.2015-84 · Cited by 80 · see citing works
The influence of endocrine treatments for breast cancer on health-related quality of life
Buijs, C., de Vries, E. G. E., Mourits, M. J. E., & Willemse, P. H. B. (2008) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2008.04.001 · Cited by 79 · see citing works
Endocrine‐related quality of life in a randomized trial of exercise on aromatase inhibitor–induced arthralgias in breast cancer survivors
Baglia, M. L., Lin, I., Cartmel, B., Sanft, T. B., Ligibel, J. A., Hershman, D. L., Harrigan, M., Ferrucci, L. M., Li, F., & Irwin, M. L. (2019) · Cancer · doi:10.1002/cncr.32051 · Cited by 80 · see citing works
“Pharmacologic therapies, such as use of nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, glucosamine, and narcotic analgesics, also have been studied to alleviate pain from AI-induced arthralgias but may be contraindicated or ineffective.(29) A randomized trial of duloxetine in 299 patients with brea…”
Background
The efficacy of acupoint stimulation for the management of therapy-related adverse events in patients with breast cancer: a systematic review
Chao, L.-F., Zhang, A. L., Liu, H., Cheng, M., Lam, H.-B., & Lo, S. K. (2009) · Breast Cancer Research and Treatment · doi:10.1007/s10549-009-0533-8 · Cited by 78 · see citing works
Musculoskeletal Adverse Events Associated with Adjuvant Aromatase Inhibitors
Khan, Q. J., O’Dea, A. P., & Sharma, P. (2010) · Journal of Oncology · doi:10.1155/2010/654348 · Cited by 75 · see citing works
“A possible biologic explanation of AIinduced musculoskeletal symptoms and their improvement with vitamin D supplementation is that reduction in joint estrogen levels may unmask subclinical Vitamin D deficiency.”
Background
Breast Cancer Medications and Vision: Effects of Treatments for Early-stage Disease
Eisner, A., & Luoh, S. (2011) · Current Eye Research · doi:10.3109/02713683.2011.594202 · Cited by 77 · see citing works
Better exercise adherence after treatment for cancer (BEAT Cancer) study: Rationale, design, and methods
Rogers, L. Q., McAuley, E., Anton, P. M., Courneya, K. S., Vicari, S. K., Hopkins-Price, P. L., Verhulst, S. J., Mocharnuk, R. S., & Hoelzer, K. L. (2011) · Contemporary Clinical Trials · doi:10.1016/j.cct.2011.09.004 · Cited by 75 · see citing works
“The improvement in joint symptoms is of clinical importance because of the current lack of effective therapies for arthralgias related to breast cancer therapy [94] and additional research to confirm our findings is warranted.”
Breast Cancer Survivorship Issues
Stan, D. L., Loprinzi, C. L., & Ruddy, K. J. (2013) · Hematology/Oncology Clinics of North America · doi:10.1016/j.hoc.2013.05.005 · Cited by 75 · see citing works
“Compared with tamoxifen, the AIs are slightly less likely to cause hot flashes.(9) In general, the symptoms that result from chemotherapy-induced menopause are more severe than those associated with natural menopause.”
Background
Sexual function in breast cancer patients: a prospective study from Iran
Harirchi, I., Montazeri, A., Bidokht, F. Z., Mamishi, N., & Zendehdel, K. (2012) · Journal of Experimental & Clinical Cancer Research · doi:10.1186/1756-9966-31-20 · Cited by 72 · see citing works
Perceptions of Patients With Breast and Colon Cancer of the Management of Cancer-Related Pain, Fatigue, and Emotional Distress in Community Oncology
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Authors: Cella, D., & Fallowfield, L. J.
Affiliations: Northwestern University (US)
Brighton and Sussex Medical School (GB)
Corresponding author: Cella, David
ORCID: Cella, David
Fallowfield, Lesley J.
Venue: Breast Cancer Research and Treatment
Publisher: Springer Science and Business Media LLC
Published: 2007-09-18
Volume: 107
Issue: 2
Pages: 167-180
ISSN: 0167-6806 (ISSN-L)
1573-7217
DOI: 10.1007/s10549-007-9548-1
OpenAlex: W2034100757
Cited by: 286
References: 83
Citations by year: 2026: 9 · 2025: 17 · 2024: 16 · 2023: 22 · 2022: 20 · 2021: 17 · 2020: 14 · 2019: 16 · 2018: 15 · 2017: 19 · 2016: 17 · 2015: 15 · 2014: 9 · 2013: 14 · 2012: 17
FWCI: 0.88
Type: journal article
Language: en
Open access: green
figshare.com
Licence: cc-by
www.springer.com/tdm (tdm)
Locations: Breast Cancer Research and Treatment (publishedVersion)
PubMed (publishedVersion)
Sussex Research Online (University of Sussex) (submittedVersion)
Figshare (submittedVersion, cc-by)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords: breast cancer, adjuvant endocrine therapy, aromatase inhibitors, tamoxifen, treatment-related adverse events, medication adherence, health-related quality of life, vasomotor symptoms, hot flashes, vaginal dryness, dyspareunia, joint pain, adverse event management, hormone receptor-positive breast cancer
MeSH terms: Aromatase, Breast Neoplasms, Clinical Trials as Topic, Endocrine System, Female, Humans, Medical Oncology, Patient Compliance, Quality of Life, Surveys and Questionnaires, Tamoxifen, Treatment Outcome, Chemotherapy, Adjuvant, Antineoplastic Agents, Hormonal, Aromatase Inhibitors

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Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy

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