Abstract
There are very few data about the efficacy and toxicity of adjuvant systemic therapies for breast cancer in non-western populations. In 1993 in Vietnam we began a randomized controlled clinical trial on premenopausal women with operable breast cancer comparing adjuvant surgical oophorectomy plus tamoxifen with observation and this same combined hormonal treatment on recurrence. We evaluated the symptoms reported at regular follow-up visits by the first 482 premenopausal women entered in this clinical trial and treated with surgical oophorectomy plus tamoxifen or observation. Hot flash frequency and intensity, vaginal discharge, and genital pruritus were the only symptoms to occur more frequently in oophorectomy and tamoxifen-treated subjects. Seventy-seven percent of oophorectomy/tamoxifen subjects reported grade 1 or more and 44% grade 2 or more hot flash frequency symptoms in the first 12 months, versus 9% and 1% of observation subjects, respectively. Twenty percent of oophorectomy/tamoxifen subjects had grade 2 or greater intensity of hot flashes some time in the first 12 months versus 0% in observation subjects. Through three years, vasomotor symptoms were reported more frequently in oophorectomy/tamoxifen-treated women (in 23% vs. 3% at three years, mostly grade I toxicities). While noted and persistent vasomotor symptoms were found with oophorectomy plus tamoxifen in this population of Vietnamese women, these were of lower grades and tolerable. This adjuvant treatment may be widely accepted if it is demonstrated to be effective in this population.
Similar content being viewed by others
References
Early Breast Cancer Trialists' Collaborative Group: Systemic treatment of early breast cancer by hormonal, cytoxic or immune therapy. 133 randomized trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Lancet 339: 1–15, 71- 85, 1992
Bonadonna G, Valagussa P, Moliterni A, Zambetti M, Brambilla C: Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer: The results of 20 years of follow-up. N EngI J Med 332: 901–906, 1995
Anh PT, Parkin DM, Hanh NT, Duc NB: Cancer in the population of Hanoi, Vietnam, 1988- 1990. Br J Cancer 68: 1236–1242, 1993
Parkin DM, Muir CS: Cancer incidence in five continents. Comparability and quality of data. IARC Scientific Publications 120: 45–173, 1992
Crump M, Sawka CA, DeBoer G, Buchanan RB, Ingle JN, Forbes J, Meakin JW, Shelley W, Pritchard KI: An individual patient-based meta-analysis of tamoxifen versus ovarian ablation as first line endocrine therapy for premenopausal women with metastatic breast cancer. Breast Cancer Res Treat 44: 201–210, 1997
Early Breast Cancer Trialists' Collaborative Group: Tamoxifen for early breast cancer: An overview of the randomised trials. Lancet 351: 1451–1467, 1998
Love RR, Cameron L, Connell BL, Leventhal H: Symptoms associated with tamoxifen treatment in postmenopausal women. Arch Intern Med 151: 1842–1847, 1991
Love RR, Mazess RB, Barden HS, Epstein S, Newcomb PA, Jordan VC, Carbone PP, DeMets DL: Effects of tamoxifen on bone mineral density in postmenopausal women with breast cancer. N EngI J Med 326: 852–856, 1992
Key TJA, Chen J, Wang DY, Pike MC, Boreham J: Sex hormones in women in rural China and in Britain. Br J Cancer 62: 631–636, 1990
Schimizer H, Ross RK, Bernstein L, Pike MC, Henderson BE: Serum estrogen levels in postmenopausal women: Comparison of American whites and Japanese in Japan. Br J Cancer 62: 451–455, 1990
Hayward JL, Greenwood FC, Glober G, Stemmerman G, Bulbrook RD, Wang DY, Kumaokas S: Endocrine status in normal British, Japanese and Hawaiian-Japanese women. Eur J Cancer 14: 1221–1228, 1978
Love RR, Fost NC: Ethical and regulatory challenges in a randomized control trial of adjuvant treatment for breast cancer in Vietnam. Westerman Prize winning entry of American Federation for Medical Research. J Clin Invest 45: 423–431, 1997
Klijn JGM, Blamey RW, Boccardo F, Tominaga T, Hoctin-Boes G, Duchateau L, Sylvester R, on behalf of CHAT: Combination LHRH-agonist plus tamoxifen treatment is superior to medical castration alone in premenopausal metastatic breast cancer: A subgroup and meta-analysis of the combined hormonal agents trialists group (CHAT). Breast Cancer Res Treat 50: 227 (Abstract 4), 1998
Rights and permissions
About this article
Cite this article
Love, R.R., Duc, N.B., Binh, N.C. et al. Symptoms associated with oophorectomy and tamoxifen treatment for breast cancer in premenopausal Vietnamese women. Breast Cancer Res Treat 58, 279–284 (1999). https://doi.org/10.1023/A:1006301812268
Issue Date:
DOI: https://doi.org/10.1023/A:1006301812268