Aromatase Inhibitor-Related Symptoms Reported by Postmenopausal Women with Nonmetastatic, Estrogen Receptor-Positive Breast Cancer: A Systematic Review

Trine Lund-Jacobsen; Line Bentsen; Peter Schwarz; Ann Søegaard Knop; Helle Pappot; Karin Piil

doi:10.1016/j.soncn.2023.151487

Aromatase Inhibitor-Related Symptoms Reported by Postmenopausal Women with Nonmetastatic, Estrogen Receptor-Positive Breast Cancer: A Systematic Review

Semin Oncol Nurs. 2023 Oct;39(5):151487. doi: 10.1016/j.soncn.2023.151487. Epub 2023 Aug 21.

Authors

Trine Lund-Jacobsen¹, Line Bentsen², Peter Schwarz³, Ann Søegaard Knop⁴, Helle Pappot⁵, Karin Piil⁶

Affiliations

¹ BSN, MSc, PhD student, Department of Endocrinology and Metabolism, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Electronic address: trine.lund-jacobsen@regionh.dk.
² MD, PhD student, Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
³ Professor, MD, DMSc, Department of Endocrinology and Metabolism, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Denmark, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
⁴ MD, PhD, Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
⁵ Professor, MD, DMSc, Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
⁶ MHScN, associate professor, Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark and Department of Publich Health, Faculty of Health, University of Aarhus, Aarhus C, Denmark.

PMID: 37612223
DOI: 10.1016/j.soncn.2023.151487

Abstract

Purpose: The objective of this systematic review was to establish an overview of aromatase inhibitor-related symptoms reported by postmenopausal women with nonmetastatic, estrogen receptor-positive breast cancer.

Data sources: Eight databases (PubMed, Cochrane, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Ovid EMBASE, Ovid MEDLINE, PsycINFO, Scopus, and Web of Science) were searched for trials published between January 2004 and November 2021. Inclusion criteria were studies exploring patient-reported aromatase inhibitor-related symptoms in postmenopausal women with nonmetastatic estrogen receptor-positive breast cancer. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Mixed Method Appraisal Tool were used to rate the quality of the trials included. Of 325 full-text papers, 10 were included. Patient-reported symptoms were clustered by using the European Organization for Research and Treatment of Cancer Quality of Life C30 questionnaire domains. Additional domains were used to cluster other symptoms mentioned: menopausal, sex-related, body alteration, and eye-related. The following clusters were the most frequently presented: sex-related (14 symptoms), pain (9 symptoms), insomnia (5 symptoms), and menopausal (5 symptoms).

Conclusion: The target group reported a variety of symptoms related to aromatase inhibitors. No tools are currently available to measure all the symptoms reported, indicating a need to revise the tools to acknowledge additional symptoms. Prospective studies are needed to investigate the prevalence of aromatase inhibitor-related symptoms in women with breast cancer.

Implication for nursing practice: Identification of patient-reported clinically relevant symptoms can enable targeted symptom assessment and management strategies for women with breast cancer undergoing aromatase inhibitor treatment.

Trial registration: ClinicalTrials.gov NCT05367830.

Keywords: Aromatase inhibitors; Breast cancer; EORTC QLQ-C30; Health-related quality of life; Patient-reported symptoms; Symptom management.

Publication types

Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Aromatase Inhibitors* / adverse effects
Breast Neoplasms* / drug therapy
Female
Humans
Postmenopause
Quality of Life
Receptors, Estrogen

Substances

Aromatase Inhibitors
Receptors, Estrogen

Associated data

ClinicalTrials.gov/NCT05367830