Abstract

Introduction Women who have been treated for breast cancer identify vasomotor symptoms, such as hot flushes and night sweats (HFNS), as a serious problem. An estimated 550 000 people live in the UK today with a diagnosis of breast cancer and up to 70% experience HFNS. Estrogen replacement remains the most effective treatment for hot flushes. However, this is contraindicated in the majority of women with estrogen‐dependent breast cancer. Fewer than 50% of women with estrogen receptor (ER) ‐positive breast cancer complete the recommended 5 years of endocrine treatment—tamoxifen and aromatase inhibitors (AIs). This lack of adherence leads to a 20% excess breast cancer mortality. This lack of adherence may be due to unacceptable side effects such as HFNS. Objectives Patient members of the National Cancer Research Institute UK Breast Clinical Studies Group identified that there is very little research into the management of symptoms after breast cancer treatment. In response we established a Working Party on Symptom Management. The members all have a particular interest in the management of HFNS, and include patients, as well as clinical and academic partners representing oncology, psychology, gynaecology, complementary therapies and the voluntary sector. Methods We gauged current clinical practice of the management of HFNS by surveying breast cancer patients, general practitioners (GPs) and healthcare professionals (HCPs) and we will present these data. Results Forty percent of patients reported that no HCPs or GPs had asked them about HFNS. Despite >90% of GPs and HCPs reporting that they prescribed drugs to alleviate HFNS, only 26% of the patients had been offered drugs and fewer than 2% said they helped; 31% of the patients said that the HFNS were severe enough for them to consider stopping endocrine therapy. Conclusion If women are to be helped to adhere to their life‐saving treatment, new approaches need to be developed to ameliorate HFNS.

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