Switching of Hormone Therapies in Breast Cancer Women

This was a retrospective cross-sectional study from a single-institution Brazilian cancer center with patient records diagnosed with breast cancer between January 2012 and January 2017.

Results

From 1,555 women who were in treatment with HT, 213 (13.7%) women had HT switched, either tamoxifen to anastrozole or vice-versa. Most women included in the present study who switched HT were > 50 years old, postmenopausal, Caucasian, and had at least one comorbidity. From the group with therapy change, ‘disease progression’ was reason of change in 124 (58.2%) cases, and in 65 (30.5%) patients, ‘presence of side effects’ was the reason. From those women who suffered with side effects, 24 (36.9%) had comorbidities.

Conclusion

The present study demonstrated a low rate of HT switch of tamoxifen to anastrozole. Among the reasons for changing therapy, the most common was disease progression, which includes cancer recurrence, metastasis or increased tumor. Side effects were second; furthermore, age and comorbidities are risk factors for side effects.

Keywords:
breast cancer; tamoxifen; hormone therapy; aromatase inhibitor; anastrozole

Characteristic	n	(%)
Age (years old)
20–49	37	17.4
≥ 50	176	82.6
Ethnicity
Caucasian	185	86.9
Non-caucasian	28	13.1
Menopause status
Premenopausal	49	23
Postmenopausal	154	72.3
Ignored	10	4.7
Comorbidity ^* * Comorbidity is all diseases besides breast cancer.
Yes	137	64.3
No	76	35.7

Modification	n	%
Reason of change
Disease progression	124	58.2
Side effect	65	30.5
Risk ^* * Risk of patient sufferiing side effects due to her comorbidities.	11	5.2
Non-adherence	5	2.3
Confirmation of menopause	4	1.9
Others	4	1.9
Total	213	100

Side effects	n	(%) ^* * Total to calculate percentage considered 65 patients, since 2 patients had two different types of side effects decisive to change their therapy.
Vascular disorders	19	29.2
Without classification ^ Side effects not classified by Common Terminology Criteria of Adverse Events (CTCAE) version 5.0.	14	21.5
Skin and subcutaneous tissue disorders	6	9.2
Musculoskeletal and connective tissue disorders	6	9.2
Gastrointestinal disorders	6	9.2
Nervous system disorders	4	6.2
Reproductive system and breast disorders	4	6.2
Eye disorders	3	4.6
General disorders and administration site conditions	3	4.6
Cardiac disorders	2	3.1

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E-mail: editorial.office@febrasgo.org.br

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[1] Address for correspondence Amanda Canato Ferracini, Pharmacist, PhD candidate, Rua Tessália Vieira de Camargo, 126, Cidade Universitária “Zeferino Vaz,” Campinas, SP, 13083-887, Brazil (e-mail: amanda.cferracini@gmail.com).