Division of Medical Oncology, Mayo Clinic, Rochester, MN, United States.
Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States.
Cancer Treat Rev. 2017 Jan;52:82-90. doi: 10.1016/j.ctrv.2016.11.012. Epub 2016 Dec 5.
Most breast cancers express estrogen and/or progesterone receptors, allowing the opportunity to use anti-estrogen therapies, which have demonstrated substantial efficacy in both the metastatic and adjuvant settings. Young premenopausal women with early-stage high-risk or with metastatic hormone-receptor positive breast cancer may benefit from ovarian function suppression in addition to anti-estrogen medications. While these endocrine manipulations have successfully improved breast cancer outcomes, they may lead to a significant proportion of women experiencing vasomotor symptoms. While not life-threatening, vasomotor symptoms adversely impact quality of life and can result in early treatment discontinuation. For these reasons, supportive management of this treatment-related toxicity is crucial, and clinicians caring for breast cancer patients and survivors should be familiar with the options available and the data behind them. This manuscript will review the pathophysiology, clinical manifestations, quality of life implications and non-estrogenic management options of vasomotor symptoms for women with breast cancer undergoing estrogen depletion.
大多数乳腺癌表达雌激素和/或孕激素受体，这使得使用抗雌激素疗法成为可能，这种疗法在转移性和辅助治疗环境中都显示出了显著的疗效。对于早期高危或转移性激素受体阳性乳腺癌的年轻绝经前妇女，除了抗雌激素药物外，还可能受益于卵巢功能抑制。虽然这些内分泌干预措施成功地改善了乳腺癌的预后，但它们可能导致相当一部分妇女出现血管舒缩症状。虽然这些症状不会危及生命，但血管舒缩症状会对生活质量产生不利影响，并可能导致早期治疗中断。出于这些原因，对这种与治疗相关的毒性进行支持性管理至关重要，照顾乳腺癌患者和幸存者的临床医生应该熟悉可用的选择及其背后的数据。本文将回顾正在接受雌激素耗竭治疗的乳腺癌女性出现血管舒缩症状的病理生理学、临床表现、对生活质量的影响和非雌激素管理选择。
