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

Clin Endocrinol (Oxf). 2016 Nov;85(5):689-693. doi: 10.1111/cen.13172. Epub 2016 Sep 1.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Hormonal / adverse effects
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Body Composition
  • Bone Resorption / etiology
  • Bone Resorption / prevention & control
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy*
  • Chemotherapy, Adjuvant / adverse effects
  • Chemotherapy, Adjuvant / methods*
  • Disease Management
  • Estradiol / deficiency
  • Female
  • Humans
  • Lipid Metabolism
  • Receptors, Estrogen

Substances

  • Antineoplastic Agents, Hormonal
  • Receptors, Estrogen
  • Estradiol