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An clause published in The Lancet Oncology reports
that postmenopausal women with breast crab who are on endocrine
treatment are likely to experience arthralgia and arthritis
(joint symptoms) if they previously have used endocrine replacement
therapy (HRT), standard a hormone-receptor positive tumour diagnosis,
undergone chemotherapy, received treatment with anastrozole versus
tamoxifen, or been weighty. Dr Ivana Sestak and Dr Jack Cuzick (Cancer
Research UK, London, UK) and colleagues hash out their results in a
retrospective exploratory analysis of patients enrolled in the Arimidex
[anastrozole] Tamoxifen Alone or in Combination trial (ATAC).
In the ATAC trial, postmenopausal women with breast cancer were
every which way assigned to anastrozole (an aromatase inhibitor) or tamoxifen.
Sestak and colleagues set extinct to determine the importance of a range of
risk factors for joint symptoms and whether the importance of these
risk of exposure factors changed according to how these women were treated. The
study sample consisted of 5,433 women who reported no joint symptoms at
the beginning of the ATAC trial.
The researchers institute that articulatio symptoms were reported by 777 of 1937
women (41.1%) who previously had used HRT and 1001 of 3496 women
(28.6%) who had not secondhand HRT. In addition:
Joint symptoms were reported by 1556 of 4596 (33.9%) with
hormone-receptor-positive tumors and in 124 of 448 (27.7%) with
hormone-receptor-negative tumors.
Joint symptoms were reported by 461 of 1176 (39.2%) world Health Organization
received late chemotherapy and in 1317 of 4257 (30.9%) who ingest not.
Obesity as measured by body-mass indicator (BMI) likewise correlated positively
with the onset of joint symptoms. About 37.2% with BMI greater than 30
kg/m�, 31.3% with BMI 'tween 25 and 30 kg/m�, and 31.0% with
BMI <25 kg/m� reported symptoms. The researchers also noticed a
difference depending on which treatment a woman received. The
percentage reporting joint symptoms in the anastrozole was 35.2%
compared to 30.3% in the tamoxifen group.
Endocrine treatment reduces the concentration of estrogen in the
body, and estrogen deficiency has been linked to joint
symptoms in several different settings. Since the effects of the risk
factors can accumulate, they need to be taken into account when
aromatase inhibitors are being considered for women. "Awareness of risk
factors for joint symptoms will help both clinicians and patients to
anticipate and manage these symptoms and ensure optimum adherence to
endocrine treatment," conclude the authors.
Risk factors for joint symptoms in patients enrolled in the
ATAC trial: a retrospective, exploratory analysis
Ivana Sestak, Jack Cuzick, Francisco Sapunar, Richard
Eastell, John F Forbes, Angelo R Bianco, Aman U Buzdar, on behalf of
the ATAC Trialists' Group
The Lancet Oncology (2008).
DOI:10.1016/S1470-2045(08)70182-7
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Written by: Peter M Crosta
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