Breast cancer surgery: quality of life depends on which one


Younger breast cancer patients who underwent mastectomy reported lower breast satisfaction and poorer psychosocial and sexual well-being compared with those who underwent breast-conserving surgery, according to results of a trial presented at the 2018 San Antonio Breast Cancer Symposium, held December 4-8.

Black women were determined to be at the most risk of dying from uterine cancer. It found that treatment to prevent the cancer from returning with chemotherapy and hormone therapy, following surgery, is not more beneficial than hormone therapy alone in patients with a low or intermediate recurrence score.

"Hot flashes not only impact quality of life; they can also be associated with premature discontinuation of breast cancer treatment, which may increase the risk of breast cancer recurrence and mortality", Leon-Ferre explained. "It is important for physicians to have effective options to treat hot flashes". This type of drug interferes with the activity of a neurotransmitter in the brain and in the peripheral nervous system.

In this study, researchers sought to determine whether oxybutynin was more effective than placebo in treating hot flashes and in improving patients' quality of life.

"Obese women have higher circulating levels of estrogen, so that tends to put them at higher risk", said Birrer. Sixty-two percent of the women were on tamoxifen or an aromatase inhibitor for the duration of the study. The women completed baseline and monthly questionnaires that tracked the frequency and severity of their hot flashes, resulting in an HF score calculated by the researchers. There were no significant differences between patients who received low EndoPredict scores, according to Myriad.

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The study found that patients on both oxybutynin doses saw decreases in hot flashes compared to the women who took the placebo. Side effects for this group included diarrhea, dry mouth, dry eyes, episodes of confusion, and difficulty urinating, but were all mild in severity.

"This study, in addition to previously published work in this area, establishes that oxybutynin is an effective drug for treatment of hot flashes in patients who have relative or absolute contraindications to hormone-based therapy", says Dr. Leon-Ferre. "We were surprised by the rapidity of the response and the magnitude of the effect, considering the relatively low dose of the drug".

"Breast cancer is the most common malignancy treated with radiation therapy in the United States", said Wendy A. Woodward, MD, PhD, Professor and Chief of the Clinical Breast Radiotherapy Service at the University of Texas MD Anderson Cancer Center.

Because oxybutynin is already available for other conditions, Leon-Ferre said doctors could prescribe it off-label.

Dominici said the study's primary limitation is that it was not randomized, and it evaluated quality of life only at a single time point. Drugs in this class - called anticholinergics - have been linked with mental decline, he said.