接受辅助内分泌治疗的乳腺癌幸存者的更年期症状与绝经期妇女的更年期症状的比较。

IF 3.9 2区 医学 Q2 GERIATRICS & GERONTOLOGY Maturitas Pub Date : 2024-10-30 DOI:10.1016/j.maturitas.2024.108143
Giorgia Asinaro , Claudia Massarotti , Anjeza Xholli , Ambrogio P. Londero , Matteo Lambertini , Paola Anserini , Lucia Del Mastro , Angelo Cagnacci
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The depression score was lower (4.63 ± 3.3 vs. 5.98 ± 3.8; <em>p</em> = 0.001) in breast cancer survivors on adjuvant endocrine therapy, mainly due to a lower score of −2.132 (95 % confidence interval − 3.858/−0.407; <em>p</em> = 0.016) for users of aromatase inhibitors. The sexuality score was higher (1.76 ± 1.1 vs. 1.50 ± 1.1, <em>p</em> = 0.011) than in controls. Differences remained significant when corrected for age, menarche, body mass index, menopausal status (peri- or post-), type of menopause (natural, surgical), use of gonadotrophin-releasing hormone analogues, years of amenorrhea, smoking, alcohol use, and for breast radiotherapy, chemotherapy, tamoxifen or aromatase inhibitors. 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引用次数: 0

摘要

研究目的:比较接受辅助内分泌治疗的乳腺癌幸存者与绝经妇女的更年期症状:比较接受辅助内分泌治疗的乳腺癌幸存者与绝经妇女的绝经症状:在一项回顾性巢式病例对照研究中,对诊断时处于绝经前、围绝经期或绝经后、服用他莫昔芬或芳香化酶抑制剂以及促性腺激素释放激素类似物(如果是绝经前或围绝经期)的乳腺癌幸存者的绝经症状,以及年龄匹配的对照组妇女的绝经症状进行了比较。此外,还评估了服用他莫昔芬和服用芳香化酶抑制剂的妇女之间的差异。根据情况采用加权和非加权t检验、卡方检验、线性或逻辑回归:格林氏 Climacteric 量表的得分,以及该量表中评估血管运动、焦虑、抑郁、躯体化和性症状的子量表的得分:共有 99 名乳腺癌幸存者(其中 45 人服用他莫昔芬,54 人服用芳香化酶抑制剂)和 554 名对照者(其中 173 人处于围绝经晚期,353 人处于自然绝经期,28 人处于手术绝经期)参加了研究。病例和对照组的格林氏更年期量表得分相似(平均值 ± 标准差)(21.3 ± 10.4 vs. 22.8 ± 11.5,p = 0.199),血管运动症状、焦虑和躯体化的分量表得分也相似。接受辅助内分泌治疗的乳腺癌幸存者的抑郁得分较低(4.63 ± 3.3 vs. 5.98 ± 3.8;p = 0.001),这主要是因为芳香化酶抑制剂使用者的抑郁得分较低,为-2.132(95 % 置信区间-3.858/-0.407;p = 0.016)。性能力得分(1.76 ± 1.1 vs. 1.50 ± 1.1,p = 0.011)高于对照组。在对年龄、初潮、体重指数、绝经状态(围绝经期或绝经后)、绝经类型(自然绝经、手术绝经)、促性腺激素释放激素类似物的使用、闭经年数、吸烟、酗酒以及乳腺放疗、化疗、他莫昔芬或芳香化酶抑制剂进行校正后,差异仍然显著。在乳腺癌幸存者中,服用芳香化酶抑制剂的妇女的焦虑(5.75 ± 2.5 vs. 5.75 ± 2.5; p = 0.045)和抑郁(3.89 ± 2.5 vs. 5.13 ± 3.6; p = 0.046)得分低于服用他莫昔芬的妇女:结论:在乳腺癌幸存者中,辅助治疗引起的症状在类型和强度上与有症状的绝经妇女相似。与绝经期妇女相比,乳腺癌幸存者,尤其是服用芳香化酶抑制剂的妇女,似乎没有那么严重的抑郁症状。
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Menopausal symptoms in breast cancer survivors on adjuvant endocrine therapy compared with those of menopausal women

Objectives

To compare menopausal symptoms of breast cancer survivors on adjuvant endocrine therapy with those of menopausal women.

Study design

In a retrospective nested case-control study menopausal symptoms were compared of breast cancer survivors in pre-, peri- or post-menopause at the time of diagnosis, on tamoxifen or an aromatase inhibitor, plus a gonadotrophin-releasing hormone analogue, if pre- or peri-menopausal, and age-matched control women either in the late peri-menopause, or in surgical or in physiological post-menopause on no hormone replacement therapy. Differences between women on tamoxifen and those on aromatase inhibitors were also evaluated. Weighted and non-weighted t-tests, chi-square tests, and linear or logistic regressions were applied as appropriate.

Main outcome measures

Score on the Greene's Climacteric Scale and so of its subscales evaluating vasomotor, anxiety, depression, somatisation and sexuality symptoms.

Results

A total of 99 breast cancer survivors (45 on tamoxifen, 54 on aromatase inhibitors) and 554 controls (173 in late perimenopause, 353 in natural and 28 in surgical menopause) were enrolled. The score on the Greene's Climacteric Scale was similar in cases and controls (means ± standard deviation) (21.3 ± 10.4 vs. 22.8 ± 11.5, p = 0.199), as were the subscale scores for vasomotor symptoms, anxiety, and somatisation. The depression score was lower (4.63 ± 3.3 vs. 5.98 ± 3.8; p = 0.001) in breast cancer survivors on adjuvant endocrine therapy, mainly due to a lower score of −2.132 (95 % confidence interval − 3.858/−0.407; p = 0.016) for users of aromatase inhibitors. The sexuality score was higher (1.76 ± 1.1 vs. 1.50 ± 1.1, p = 0.011) than in controls. Differences remained significant when corrected for age, menarche, body mass index, menopausal status (peri- or post-), type of menopause (natural, surgical), use of gonadotrophin-releasing hormone analogues, years of amenorrhea, smoking, alcohol use, and for breast radiotherapy, chemotherapy, tamoxifen or aromatase inhibitors. Among breast cancer survivors, women on aromatase inhibitors had lower scores for anxiety (5.75 ± 2.5vs.5.75 ± 2.5; p = 0.045) and depression (3.89 ± 2.5 vs. 5.13 ± 3.6; p = 0.046) than women on tamoxifen.

Conclusions

In breast cancer survivors, adjuvant therapy induces symptoms similar in type and intensity to those of symptomatic menopausal women. Compared with menopausal women, breast cancer survivors, particularly those on aromatase inhibitors, appear to experience less severe depressive symptoms.
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来源期刊
Maturitas
Maturitas 医学-妇产科学
CiteScore
9.10
自引率
2.00%
发文量
142
审稿时长
40 days
期刊介绍: Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care. Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life
期刊最新文献
Corrigendum to “Prevalence and impact of vasomotor symptoms associated with menopause among women in Brazil: Subgroup analysis from an international cross-sectional survey” [Maturitas 189 (2024) 108114] Prevalence of menopausal symptoms around the time of the final menstrual period in Japanese women: Data from the Japan Nurses' Health Study Methods for the assessment of biological age – A systematic review Exploring the experiences of adult patients with turner syndrome at a multidisciplinary clinic Self-care experiences and behaviors in people with osteoporosis: A meta-synthesis
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