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HT does not ease hot flashes from tamoxifen therapy: quality of life, adherence affected.(News)
SAN ANTONIO -- Hormone therapy isn't effective for hot flashes in women on tamoxifen, Ivana Sestak, Ph.D., reported at a breast cancer symposium sponsored by the Cancer Therapy and Research Center.
This was the clear-cut conclusion of a new secondary analysis of the International Breast Cancer Intervention Study I (IBIS-I), in which 7,152 postmenopausal women at increased breast cancer risk were randomized to 20 mg/day of tamoxifen or placebo.
The new finding is unwelcome news for women on tamoxifen for breast cancer chemoprevention who find their vasomotor symptoms intolerable. Those who don't solve their problems by discontinuing tamoxifen have often turned to hormone therapy (HT) in an effort to find relief, despite the fact that HT is believed to confer a modest increase in breast cancer risk.
The primary results of IBIS-I, in which tamoxifen reduced the risk of breast cancer by one-third over 4 years, have been published (Lancet 2002;360:817-24). The secondary analysis focused on quality of life issues, which for many women on tamoxifen are chiefly vasomotor symptoms.
Indeed, 71% of women in the tamoxifen group of IBIS-I reported hot flashes during 84 months of follow-up, compared with 57% on placebo. Most were rated mild to moderate. But 12% of affected women in the tamoxifen group had severe hot flashes, a rate twice that in the placebo group, said Dr. Sestak of Cancer Research UK, London.
Menstrual irregularities and night sweats were also 33%-54% more common among tamoxifen-treated women than placebo-treated women. Nevertheless, these vasomotor symptoms were much less of an issue than the hot flashes, as they affected only 11% and 4%, respectively, of women on tamoxifen.
HT was effective in curbing hot flashes in the placebo group. For example, among placebo-treated women who were current HT users at study entry, the prevalence of hot flashes at the 6-month follow-up visit was 23%, compared with 34% among HT-nonusers. ...
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