Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.
Bill Walsh Laboratory, Kolling Institute, Level 8, Reserve Road, St Leonards, NSW, 2065, Australia.
Breast Cancer. 2021 Nov;28(6):1243-1251. doi: 10.1007/s12282-021-01260-x. Epub 2021 May 11.
We aimed to improve understanding of health professional knowledge and management of genitourinary symptoms (GUS) in women with early breast cancer (EBC).
A survey was sent to 872 health professionals caring for women with EBC. Questions addressed most common GUS seen, experience treating GUS, and attitudes to treatment options.
144 surveys were completed. Respondent characteristics: median age 50 years; 76% female; 42% medical oncologists; 24% nurses; 20% breast surgeons; 8% radiation oncologists. Most (68%) reported prescribing endocrine therapies for EBC, 99% were aware endocrine therapies can cause GUS, and 55% reported "often" or "always" asking patients on endocrine therapy if they have GUS. Respondents thought vaginal dryness was the most bothersome symptom for their patients (66%), followed by dyspareunia (11%). 81% of respondents reported seeing women stop endocrine therapy prematurely due to GUS. Respondents reported receiving "none" (19%) or "a little" (46%) training or education in managing GUS and only 16% reported feeling "very confident" managing GUS. The proportions of respondents reporting "often" and "very often" recommending the following vaginal treatments were: lubricants (81%); moisturisers (68%); oestrogens (21%); and laser (3%). Vaginal oestrogens were considered "safe" or "probably safe" by 77% and 90% of respondents for women with hormone receptor positive and negative EBC, respectively.
Despite health professionals frequently encountering GUS in women with EBC and seeing patients stop endocrine therapies prematurely, only 16% felt confident managing these symptoms. Education and training for health professionals are needed to better address this common problem.
我们旨在提高对患有早期乳腺癌(EBC)女性的泌尿生殖系统症状(GUS)的健康专业知识和管理的理解。
向 872 名照顾 EBC 女性的健康专业人员发送了一份调查。问题涉及最常见的 GUS、治疗 GUS 的经验以及对治疗选择的态度。
完成了 144 份调查。受访者特征:中位年龄 50 岁;76%为女性;42%为肿瘤内科医生;24%为护士;20%为乳腺外科医生;8%为放射肿瘤学家。大多数(68%)报告为 EBC 开具内分泌治疗药物,99%知道内分泌治疗会引起 GUS,55%报告在开具内分泌治疗药物时“经常”或“总是”询问患者是否有 GUS。受访者认为阴道干燥是患者最困扰的症状(66%),其次是性交困难(11%)。81%的受访者报告因 GUS 导致女性提前停止内分泌治疗。受访者报告接受了“无”(19%)或“少许”(46%)的管理 GUS 的培训或教育,只有 16%表示对管理 GUS“非常有信心”。报告“经常”和“非常经常”推荐以下阴道治疗方法的受访者比例分别为:润滑剂(81%);保湿剂(68%);雌激素(21%);和激光(3%)。阴道雌激素被 77%和 90%的分别认为对激素受体阳性和阴性的 EBC 女性是“安全”或“可能安全”。
尽管健康专业人员经常在患有 EBC 的女性中遇到 GUS 并看到患者提前停止内分泌治疗,但只有 16%的人对管理这些症状有信心。需要对健康专业人员进行教育和培训,以更好地解决这一常见问题。