title: Vaginal oestrogen therapy after breast cancer: is it safe?
abstract: The increasing number of breast cancer patients who suffer from menopausal symptoms is mainly due to the extensive use of adjuvant treatments in the younger women. Both short and long-term side effects of oestrogen deficiency may severely impact on the quality of life of these women and should not be underestimated. Hormonal treatments are contraindicated in breast cancer survivors mainly due to the concern that dormant micrometastases may be stimulated to grow. Alternative non-hormonal remedies are now available to alleviate symptoms and to prevent chronic diseases associated with oestrogen deficiency. Urogenital atrophy is an important consequence of oestrogen deprivation that can be effectively treated by vaginal estrogens, although systemic absorption occurs with conventional doses. Preliminary data suggest that much lower doses of vaginal estrogens can alleviate urogenital atrophy without influencing serum estrogenic levels. Further research is warranted to confirm whether vaginal estrogens are safe in symptomatic breast cancer patients who are non-responsive to alternative treatments.
authors.affiliation: Academic Department of Gynaecological Oncology, University of Turin, Mauriziano Umberto I Hospital of Turin and Institute for Cancer Research and Treatment of Candiolo, Largo Turati 62, Turin 10129, Italy. rponzone@mauriziano.it
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ponzone
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Biglia
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Jacomuzzi
authors.forename: Furio
authors.initials: F
authors.lastname: Maggiorotto
authors.forename: Luca
authors.initials: L
authors.lastname: Mariani
authors.forename: Piero
authors.initials: P
authors.lastname: Sismondi
mesh_terms: D000282:Administration, Intravaginal; D001943:Breast Neoplasms / Q000150:complications*; D002986:Clinical Trials as Topic; D004967:Estrogens / Q000008:administration & dosage / Q000009:adverse effects* / Q000172:deficiency; D005260:Female; D052776:Female Urogenital Diseases / Q000517:prevention & control*; D006801:Humans; D008593:Menopause / Q000187:drug effects*
chemical_list: D004967:Estrogens