Adjuvant endocrine therapy side-effects among postmenopausal breast cancer patients in Malaysia

Abstract

Objective: This study was conducted to determine the prevalence and severity of menopausal symptoms and their associated risk factors among postmenopausal breast cancer patients receiving adjuvant endocrine therapy.

Methods: Postmenopausal breast cancer patients on endocrine therapy were recruited at three hospitals in Malaysia. Presence and severity of menopausal symptoms were determined using the Menopause Rating Scale. Sociodemographic and clinical data were collected from medical records.

Results: A total of 192 patients participated in this study. Commonly reported symptoms were musculoskeletal pain (59.9%), physical and mental exhaustion (59.4%), and hot flushes (41.1%). Multivariate analyses indicated that increasing number of years after menopause until the start of endocrine therapy was significantly associated with less likelihood of reporting menopausal symptoms and musculoskeletal pain. Patients with primary or secondary education levels reported significantly less menopausal urogenital symptoms compared to patients with a tertiary education level. Patients using aromatase inhibitors were twice as likely to experience musculoskeletal pain compared to patients using tamoxifen (odds ratio, 2.18; 95% confidence interval, 1.06–4.50; p < 0.05).

Conclusion: Menopausal symptoms and musculoskeletal pain are common problems encountered by postmenopausal breast cancer patients receiving adjuvant endocrine therapy and should be closely monitored for successful treatment.

摘要

目的：本研究旨在确定接受辅助内分泌治疗的绝经后乳腺癌患者绝经症状的患病率和严重程度, 及其相关危险因素。

方法：在马来西亚的三家医院招募接受内分泌治疗的绝经后乳腺癌患者。绝经症状的存在和严重程度采用绝经评分量表测定。社会人口学和临床数据从病历中收集。

结果：共192名患者参与本研究。常见症状有骨骼疼痛（59.9%）, 身心疲惫（59.4%）, 潮热（41.1%）。多变量分析表明, 更年期至内分泌治疗开始的年数增加, 与绝经症状和骨骼疼痛可能性降低显著相关。与接受高等教育的患者相比, 接受初等或中等教育的患者报告绝经后泌尿生殖系统症状显著减少。服用芳香化酶抑制剂的患者发生肌肉骨骼疼痛的可能性是服用他莫西芬患者的两倍（比值比, 2.18；95%置信区间, 1.06-4.50；p<0.05）。

结论：绝经症状和肌肉骨骼疼痛是接受辅助内分泌治疗的绝经后乳腺癌患者遇到的常见问题, 应密切关注其治疗效果。

Keywords:

• Adjuvant endocrine therapy
• breast cancer
• Malaysia
• postmenopausal

Acknowledgements

The authors thank all the physicians, staff nurses, and patients at the Universiti Kebangsaan Malaysia Medical Centre, Hospital Kuala Lumpur, and National Cancer Institute for their support. They also thank Universiti Kebangsaan Malaysia for funding this research. The authors also thank N. Z. Mohd Saat for assistance with statistical analysis. They acknowledge the Director General of the Ministry of Health, Malaysia for permission to publish this article.

Conflict of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was funded by Universiti Kebangsaan Malaysia [grant code GUP-2016-035].