Adjuvant endocrine therapy in women with oestrogen-receptor-positive breast cancer: how should the skeletal and vascular side effects be assessed and managed?

Summary Adjuvant endocrine therapy provides oncological benefits in women with early oestrogen‐receptor‐positive breast cancer, but has adverse effects consequent to induced oestradiol deficiency. Bone loss is accelerated, predisposing to increased fracture risk. Metabolic effects include changes in...

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Bibliographic Details
Published in:Clinical endocrinology (Oxford) 2016-11, Vol.85 (5), p.689-693
Main Authors: Ramchand, Sabashini K., Lim, Elgene, Grossmann, Mathis
Format: Article
Language:English
Subjects:
Androgens
Antineoplastic Agents, Hormonal - adverse effects
Antineoplastic Agents, Hormonal - therapeutic use
Body Composition
Bone Resorption - etiology
Bone Resorption - prevention & control
Breast cancer
Breast Neoplasms - complications
Breast Neoplasms - drug therapy
Chemotherapy, Adjuvant - adverse effects
Chemotherapy, Adjuvant - methods
Disease Management
Endocrine therapy
Estradiol - deficiency
Female
Humans
Lipid Metabolism
Receptors, Estrogen
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Summary:Summary Adjuvant endocrine therapy provides oncological benefits in women with early oestrogen‐receptor‐positive breast cancer, but has adverse effects consequent to induced oestradiol deficiency. Bone loss is accelerated, predisposing to increased fracture risk. Metabolic effects include changes in lipid metabolism and body composition although effects on cardiovascular risk are still unclear. Women commencing endocrine therapy should be proactively counselled about and monitored for these and other therapy‐related complications including arthralgia and vasomotor symptoms. We provide strategies for prevention and management of these adverse effects, based, where available, on randomized controlled trial evidence specific to breast cancer survivors receiving endocrine treatment.
ISSN:0300-0664
1365-2265
DOI:10.1111/cen.13172