The impact of endocrine therapy on patients with breast cancer: a review of the literature.

This paper reviews studies which have examined the impact of endocrine therapy on the quality of life (QOL) of patients with breast cancer. In patients with primary disease, published studies suggest that endocrine therapies, such as tamoxifen, significantly increase both gynaecological and vasomotor symptoms. However, few studies have been able to demonstrate the impact which these symptoms have on patients' QOL. This failure can be partially attributed to a range of methodological problems. Psychosocial research in advanced disease has largely consisted of randomized controlled studies with QOL as one of several study endpoints. Second generation treatments, such as aromatase inhibitors, have frequently been compared with older treatments, such as progestin therapies. Unfortunately, QOL data reported in these studies have tended to be fairly limited. Problems with existing QOL research in endocrine treatment are discussed and recommendations are made for further work.