Vaginal estrogen therapy in postmenopausal breast cancer patients treated with aromatase inhibitors

Moegele, M.; Buchholz, Stefan; Seitz, Stephan; Ortmann, O.

doi:10.1007/s00404-011-2181-6

Cited by 59 publications

(30 citation statements)

References 54 publications

(44 reference statements)

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“…However, it is absorbed systemically to some extent and has been shown to increase serum estradiol levels to variable degrees [86,87]. This raises some concerns about the safety of vaginal estrogens in patients with breast cancer, particularly in patients on AI though the clinical implications of this increase in estrogen on breast cancer outcomes is unclear [82,86]. No increased risk of breast cancer recurrence was observed in a small cohort study (n=69) of women with breast cancer receiving topical vaginal estrogen [88].…”

Section: Vulvovaginal Symptomsmentioning

confidence: 93%

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Endocrine Therapy in Older Women with Early-Stage Hormone Sensitive Breast Cancer

Hsu¹,

Sud²

2017

J Gerontol Geriatr Res

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Breast cancer is the most common cancer affecting women worldwide, with the highest risk in those aged 70 and over. Most older women (80% to 85%) have hormone receptor positive breast cancer and thus the use of endocrine therapy is common in this population. Typically, women receive endocrine therapy for at least 5 years to reduce the risk of cancer recurrence and decrease breast-cancer mortality. However, adherence to hormonal therapy may be an issue, particularly in older women, as side effects may lead to early discontinuation and/or non-adherence. Older women on endocrine therapy are often cared for by primary care physicians and geriatricians and therefore, an understanding of oral endocrine therapy, as well as its potential side effects, is essential for treating physicians. This review describes the benefits of endocrine therapy in patients with resected breast cancer, compare different hormonal therapies with regards to side-effects and discuss management strategies with a particular focus on the concerns of older breast cancer patients on endocrine therapy. Mrs. Smith is a 75-year-old woman whose family doctor noted a 3 cm to 4 cm lump in her left breast during a routine physical exam. She has no palpable lymph nodes. Her family doctor sends her for a mammogram which reveals a 2.6 cm spiculated mass in the left upper outer quadrant. Biopsy reveals an invasive ductal carcinoma.

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Section: Vulvovaginal Symptomsmentioning

confidence: 93%

“…Potential vaginal irritants such as scented toilet paper, soaps and fabric softeners, as well as synthetic garments should be avoided [59,82]. Regular sexual activity may help promote blood flow to the area improving vaginal atrophy [83].…”

Section: Vulvovaginal Symptomsmentioning

confidence: 99%

Endocrine Therapy in Older Women with Early-Stage Hormone Sensitive Breast Cancer

Hsu¹,

Sud²

2017

J Gerontol Geriatr Res

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“…Le Ray et al n'ont pas rapporté d'augmentation du risque de récidive de cancer mammaire chez les patientes ménopausées ou non, sous Tamoxifène ou anti-aromatase, avec des sécheresses vaginales traitées par OL par rapport au groupe témoin (sans OL) (RR = 0,78 ; IC95 % : 0,48-1,25) [43], mais il s'agissait d'une étude de cohorte rétrospec-tive de faible niveau de preuve. Cependant, aucune donnée de sécurité de niveau de preuve élevé ne peut actuellement autoriser la prescription d'Estradiol ou d'Estrone sous forme locale chez les patientes ayant un antécédent de carcinome mammaire [44,45]. Chez ces dernières, l'utilisation des traitements locaux hormonaux, y compris à faible dose, constitue une contre indication relative et devra être discutés en concertation pluridisciplinaire.…”

Section: Seinunclassified

Œstrogénothérapie locale en urologie et pelvi-périnéologie. Revue de littérature

Benoit

Leguevaque

Roumiguié

et al. 2015

Progrès en Urologie

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“…A few small studies have demonstrated significant increases in plasma estradiol concentrations in postmenopausal breast cancer patients on AIs treated with local vaginal estrogen therapy (LVET). However, no studies to date have revealed an increased risk of breast cancer recurrence with LVET use [49] . It is becoming increasingly evident that severe VVA can have a negative impact on quality of life and may result in medication noncompliance.…”

Section: Management Of Vulvovaginal Atrophy In the Breast Cancer Survmentioning

confidence: 99%

Caring for the breast cancer survivor’s health and well-being

Casey¹

2014

WJCO

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The breast cancer care continuum entails detection, diagnosis, treatment, and survivorship. During this time, focus on the whole woman and medical concerns beyond the breast cancer diagnosis itself is essential. In this comprehensive review, we critically review and evaluate recent evidence regarding several topics pertinent to and specific for the woman living with a prior history of breast cancer. More specifically, we discuss the most recent recommendations for contraceptive options including long-acting reversible contraception and emergency contraception, fertility and pregnancy considerations during and after breast cancer treatment, management of menopausal vasomotors symptoms and vulvovaginal atrophy which often occurs even in young women during treatment for breast cancer. The need to directly query the patient about these concerns is emphasized. Our focus is on non-systemic hormones and non-hormonal options. Our holistic approach to the care of the breast cancer survivor includes such preventive health issues as sexual and bone health,which are important in optimizing quality of life. We also discuss strategies for breast cancer recurrence surveillance in the setting of a prior breast cancer diagnosis. This review is intended for primary care practitioners as well as specialists caring for female breast cancer survivors and includes key points for evidence-based best practice recommendations.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Breast cancer; Contraception; Vasomotor symptoms; Vulvovaginal atrophy; Sexual health; Osteopenia; Osteoporosis; Breast cancer recurrence; Breast cancer surveillance Core tip: Caring for women with breast cancer at the time of diagnosis, during, and after treatment goes well beyond addressing the breast cancer alone. Holistic care includes safe, effective and convenient contraceptive options;local progestin intrauterine contraception may present an option for some breast cancer survivors. Discussion regarding the effects of chemotherapy on future fertility and pregnancy is an important part of survivorship care for women in child-bearing years. Addressing the effects of breast cancer treatment including vasomotor symptoms, vulvovaginal atrophy and sexual well-being is vital for all breast cancer survivors, but especially important in the setting of adjuvant therapy with aromatase inhibitors.

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Vaginal estrogen therapy in postmenopausal breast cancer patients treated with aromatase inhibitors

Cited by 59 publications

References 54 publications

Endocrine Therapy in Older Women with Early-Stage Hormone Sensitive Breast Cancer

Endocrine Therapy in Older Women with Early-Stage Hormone Sensitive Breast Cancer

Œstrogénothérapie locale en urologie et pelvi-périnéologie. Revue de littérature

Caring for the breast cancer survivor’s health and well-being

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