Acupuncture for joint symptoms related to aromatase inhibitor therapy in postmenopausal women with early-stage breast cancer: a narrative review.
BACKGROUND
Aromatase inhibitor-induced musculoskeletal syndrome (AIMSS) leads to discontinuation of aromatase inhibitor therapy in a significant proportion of patients with breast cancer. Acupuncture is popular among cancer patients and has previously been shown to improve symptoms in a range of musculoskeletal complaints.


OBJECTIVE
To determine the effectiveness and safety of acupuncture for the management of AIMSS in postmenopausal women with early-stage breast cancer.


METHODS
A literature search was carried out for randomised controlled trials (RCTs) on acupuncture for AIMSS in postmenopausal women with early-stage breast cancer. Characteristics of trials and outcomes were extracted from the retrieved articles, which were also assessed for risk of bias and quality of reporting.


RESULTS
Four RCTs were retrieved of sample size 32-67 (totalling 190 participants). Compliance with treatment was high and rates of adverse events were low. Of the three two-arm RCTs, two found no difference between acupuncture and sham acupuncture and one found that acupuncture was statistically superior to sham acupuncture. The fourth RCT, which incorporated three arms, found acupuncture and sham acupuncture to be statistically superior to usual care but there was no difference between true and sham acupuncture. Three trials that used non-penetrating sham as the control found no effect of acupuncture over sham, but the one trial that used superficial needle insertion found acupuncture to be superior.


CONCLUSIONS
Acupuncture is safe and results in improvement in AIMSS symptoms, but similar benefits are also elicited by non-penetrating sham acupuncture. Future research should seek to establish the durability of improvements.
Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
Elizabeth J
http://orcid.org/0000-0002-4040-5315
EJ
Halsey
Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
Mei
M
Xing
Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
Rachel C
RC
Stockley
D015670:Acupuncture Therapy; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000628:therapy*; D017698:Postmenopause / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic
D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors
ACUPUNCTURE