The impact of adjuvant endocrine therapy in early breast cancer on quality-of-life: an overview of prospective trials

ABSTRACT Although endocrine therapy (ET) plays a crucial role in the adjuvant treatment of ER-positive breast cancer, a significant proportion of patients discontinue treatment early because of toxicity. In recent years a number of papers have attempted to quantify the impact of adjuvant ET on the quality-of-life (QOL) of the patient. The aim of this present review is to report the results of prospective trials that have measured the effect of adjuvant ET on the QOL in breast cancer patients. In most trials a great discrepancy has emerged between the magnitude of treatment-related symptoms and a drop in different QOL domains. In fact, the average change of QOL scores, if present, was unexpectedly small. Moreover, aromatase inhibitors were shown to have an unfavorable profile when compared to tamoxifen, in the up-front or switched schedule, or to placebo, in the extended strategy. Further studies are warranted to implement more sensitive and largely accepted QOL instruments.