Hot flushes in breast cancer patients.
OBJECTIVE
A literature search was conducted to gather information concerning the pathophysiologic mechanisms leading to hot flushes, their prevalence and severity in breast cancer patients, their influence on quality of life, and the best therapeutic option.


METHODS
Relevant studies in English were selected from Medline.


CONCLUSIONS
Pathophysiologic mechanisms leading to hot flushes are poorly understood. Estrogen withdrawal is considered to have a central role. Also, serotonin and norepinephrine seem to be involved in hot flush induction. Menopause induced by chemotherapy or ovarian ablation, is accompanied by an abrupt decrease in estrogen level, causing vasomotor symptoms. Hot flushes are also a side effect of tamoxifen and aromatase inhibitors. Quality of life in breast cancer patients may be negatively influenced by hot flushes, and therefore, adequate treatment is important. Currently, of the several non-hormonal options, the selective serotonin-reuptake inhibitor (SSRI) venlafaxine is the most effective in breast cancer patients. However, studies on interaction between SSRIs and tamoxifen may influence future recommendations.
Mom
Constantijne H
CH
Department of Medical Oncology, University Medical Center, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
Buijs
Ciska
C
Willemse
Pax H B
PH
Mourits
Marian J E
MJ
de Vries
Elisabeth G E
EG
D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013565:Sympatholytics / Q000627:therapeutic use
D014151:Anti-Anxiety Agents; D000970:Antineoplastic Agents; D017367:Selective Serotonin Reuptake Inhibitors; D013565:Sympatholytics