Assessment of hot flashes and clinical correlates in breast cancer patients receiving tamoxifen or third-generation aromatase inhibitors

Abstract

8015 Background: The aim of this study was to assess prevalence and severity of hot flashes in breast cancer patients with or without endocrine treatment and to identify patients at risk in whom interventions may be necessary. Methods: 233 postmenopausal breast cancer patients belonging to various stages were included in this cross-sectional study. They completed local treatments and chemotherapy for at least 3 months and were without evidence of disease progression on inclusion. Current hormonal treatments were: None, 58 pts; tamoxifen, 79 pts; FEMTA trial (double blind adjuvant tamoxifen vs letrozole) 49 pts; letrozole, 26 pts; exemestane, 21 pts. Frequency and severity of hot flashes and other menopausal symptoms were recorded in a 14-day diary. Statistical analysis was done with non-parametric test Mann-Whitney U test and Pearson’s correlation test. Results: Prevalence of hot flashes was highest under tamoxifen (70%) and in the FEMTA trial (69%). Hot flashes were less frequent in patients without hormonal therapy (52%) and in patients under aromatase inhibitors (49%), both groups being significantly different than patients receiving tamoxifen (p=0.054 and p= 0.013, respectively). No significant difference in hot flashes was seen when comparing aromatase inhibitors vs no hormonal therapy, or tamoxifen vs FEMTA. Age was inversely correlated with occurrence of hot flashes (p< 0.0001). Patients with lower educational level and those in partnered relationships reported more hot flashes (all p≤ 0.046). Moreover, the occurrence of hot flashes was significantly correlated to the presence of nervousness and depressive mood (p=0.02) and was associated with other menopausal symptoms such as vaginal dryness (p=0.073) and memory problems (p=0.072). Conclusions: Although hot flashes are most severe under tamoxifen, a significant proportion of patients receiving third generation aromatase inhibitors and even untreated patients experience this symptom. This underscores the need for finding effective and safe non-hormonal interventions. No significant financial relationships to disclose.