Using patient-reported outcomes to assess the effectiveness of topical hormonal replacement therapy (THR) for vaginal complaints (VC) after anti-hormonal therapy (HT) treatment for breast cancer (BC).

Abstract

77 Background: THR is sometimes used for treatment of VC in BC patients previously treated with HT. The safety of this practice remains a question but the effectiveness of this strategy has not been reported. Methods: We conducted a retrospective analysis of patient reported symptoms at the West Cancer Center (WCC) between 2002 and 2014. Early stage BC patients previously treated with HT with reported VC ± THR were statistically matched 1:1 using propensity score matching with calipers of 0.01. Demographics and clinical characteristics were extracted from electronic records and a proprietary patient-reported outcomes database: the Patient Care Monitor (PCM). A baseline PCM score for vaginal dryness and sexual dysfunction was noted at the initiation of THR and was followed for 12 months. Univariate statistics compared the resulting cohorts and repeated measures ANOVA assessed the impact of topical therapy. Results: We compared 74 THR patients to 74 controls (Table). The mean reported symptom scores were 3 fold higher in the active group with no statistical improvement in symptom scores noted at 6 or 12 months (Table). At the WCC, of the 5,479 patients with VC analyzed, only 5% received THR. The study was underpowered for survival analysis. Conclusions: In our study, increased severity of VC was associated with increased use of THR. However, there is no evidence that THR was effective in alleviating symptoms of vaginal dryness or sexual dysfunction. [Table: see text]