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Effects of Switching from Tamoxifen to Anastrozole on Tamoxifen-Related Endocrine Symptoms and Quality of Life

In Early Breast Cancer Patients

  • Original Research Article
  • Published:
American Journal of Cancer

Abstract

Objective:To determine the effects on menopausal symptoms and quality of life of switching from tamoxifen to anastrozole as adjuvant endocrine treatment for early breast cancer patients.

Patients and methods:Forty-four women who had completed primary breast cancer treatment (surgery ± radiotherapy ± chemotherapy), were postmenopausal, and had switched from tamoxifen to anastrozole as adjuvant hormonal treatment because of tolerability issues were enrolled. Endocrine symptoms and health-related quality of life were assessed by the series of Functional Assessment of Cancer Therapy-Breast (FACT-B) and endocrine subscale (ES) questionnaires at the time of the switch and 12 months later, and by the ES alone at 3, 6, and 9 months after switching. Sample size was decided by the effect size method, with a standard deviation fixed at 0.5, the conventionally accepted value representative of an effect of medium value. To evaluate score modifications, one-way ANOVAs were applied.

Results:Endocrine symptoms improved between baseline and 3 months and stabilized thereafter. Improvements in mean ES scores from baseline were +3 (95% CI 1, 5), +4 (95% CI 3, 6), +5 (95% CI 3, 7), and +4 (95% CI 3, 6) at 3, 6, 9, and 12 months, respectively. The FACT-ES global score showed a mean improvement over 12 months of 9 points (95% CI 6, 13; p < 0.0005). A statistically significant improvement in Trial Outcome Index scores from baseline to 12 months (+4 points [95% CI 2, 6; p < 0.0005]) and in the physical and breast cancer subscales (+2 [95% CI 1, 2; p < 0.001] and +1 [95% CI 1, 2; p < 0.001]) was also observed. Compared with tamoxifen treatment, patients receiving anastrozole reported significantly higher rates of mild arthritic and bone pain (27%vs 7%; p = 0.021)

Conclusion:This study evaluated a small population of 44 patients who had switched from tamoxifen to enastrozole mainly because of gynecologic adverse effects with tamoxifen. However, the results of this study suggest that a change to anastrozole as adjuvant therapy should be considered for patients who develop endocrine symptoms while receiving tamoxifen to minimize those symptoms and improve quality of life.

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Acknowledgments

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Correspondence to Cristian Massacesi.

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Massacesi, C., Sabbatini, E., Zepponi, L. et al. Effects of Switching from Tamoxifen to Anastrozole on Tamoxifen-Related Endocrine Symptoms and Quality of Life. Am J Cancer 5, 433–440 (2006). https://doi.org/10.2165/00024669-200605060-00009

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  • DOI: https://doi.org/10.2165/00024669-200605060-00009

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