Obstetrics and Gynaecology Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, School of Medicine, Turin, Italy.
Obstetrics and Gynaecology Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, School of Medicine, Turin, Italy.
Clin Breast Cancer. 2017 Dec;17(8):611-617. doi: 10.1016/j.clbc.2017.05.008. Epub 2017 May 19.
Vulvovaginal atrophy (VVA) is a relevant problem for breast cancer survivors (BCSs), in particular for those who receive aromatase inhibitors (AIs). We conducted a survey, to assess the attitude of oncologists toward the diagnosis and treatment of VVA in BCSs.
In 2015, 120 computer-assisted Web interviews were performed among breast oncologists.
According to oncologists' perceptions, 60% of postmenopausal BCSs and 39.4% of premenopausal BCSs will suffer from VVA. Despite that none of the physicians considered VVA as a transient event or a secondary problem in BCSs, only half of the oncologists (48%) directly illustrated VVA to the patients as a possible consequence. Forty-one percent of the oncologists refer BCSs to gynaecologist to define VVA treatment, whereas 35.1% manages it alone. Nonhormonal treatments are preferred by most oncologists (71%). The main reason not to prescribe vaginal estrogen therapy in BCSs is the fear of increased cancer recurrence, the possible interference with tamoxifen, or AIs and the fear of medical litigation.
VVA is a relevant problem for BCSs. Great effort should be done to correctly inform health care providers about VVA problems and on the different possible available treatments.
外阴阴道萎缩(VVA)是乳腺癌幸存者(BCS)的一个相关问题,特别是那些接受芳香化酶抑制剂(AIs)的患者。我们进行了一项调查,以评估肿瘤学家对 BCS 中 VVA 的诊断和治疗的态度。
2015 年,对 120 名乳腺肿瘤学家进行了计算机辅助的网络访谈。
根据肿瘤学家的看法,60%的绝经后 BCS 和 39.4%的绝经前 BCS 将患有 VVA。尽管没有医生认为 VVA 是 BCS 的短暂事件或次要问题,但只有一半的肿瘤学家(48%)直接向患者说明 VVA 是可能的后果。41%的肿瘤学家将 BCS 转介给妇科医生以确定 VVA 的治疗方法,而 35.1%的肿瘤学家则独自管理。大多数肿瘤学家更喜欢非激素治疗(71%)。不向 BCS 开具阴道雌激素治疗的主要原因是担心癌症复发增加、可能与他莫昔芬或 AIs 发生干扰,以及担心医疗诉讼。
VVA 是 BCS 的一个相关问题。应努力向医疗保健提供者正确告知 VVA 问题以及不同的可用治疗方法。