title: Impact of Adjuvant Endocrine Therapy on Quality of Life and Symptoms: Observational Data Over 12 Months From the Mind-Body Study.
abstract: OBJECTIVE
  To examine patterns of health and symptoms associated with the initiation of adjuvant endocrine therapy (ET) for primary breast cancer treatment.
  
  
  METHODS
  The mind-body study (MBS) observational cohort participants provided self-reported data on physical and mental health, ET-related symptoms, as well as depression, fatigue, and sleep obtained at enrollment (after primary treatment, prior to initiation of ET) and 6 and 12 months later. Longitudinal trajectories of outcome variables among three patient groups (no ET, aromatase inhibitor [AI], or tamoxifen) were compared by using linear mixed models.
  
  
  RESULTS
  Two-thirds of the 186 women initiated ET, which was evenly split between AI and tamoxifen, and no significant differences were observed in self-reported measures among the groups at baseline or in covariate-adjusted analyses. Physical health scores were below normative levels initially and improved over time, but the AI group had a significantly lower score at 12 months (P = .05); mental health scores were within the normal range, were similar in each group, and did not change over time. The no-ET group showed either stable or declining symptom severity, whereas the ET groups often showed increased severity over time, and the AI group reported more severe musculoskeletal (P = .02), hot flash (P = .02), and cognitive problems (P = .006) at one or both of the follow-up time points compared with the no-ET group. The tamoxifen group had higher levels of hot flashes (P = .002), cognitive problems (P = .016), and bladder problems (P = .02) than the no-ET group.
  
  
  CONCLUSIONS
  Attention should be given to the increased symptom burden associated with ET, and better efforts should be made to address patient-reported outcomes.
authors.affiliation: All authors: University of California, Los Angeles, Los Angeles, CA. pganz@mednet.ucla.edu.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
authors.affiliation: All authors: University of California, Los Angeles, Los Angeles, CA.
authors.forename: Laura
authors.initials: L
authors.lastname: Petersen
authors.affiliation: All authors: University of California, Los Angeles, Los Angeles, CA.
authors.forename: Julienne E
authors.initials: JE
authors.lastname: Bower
authors.affiliation: All authors: University of California, Los Angeles, Los Angeles, CA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Crespi
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D019222:Mind-Body Relations, Metaphysical / Q000187:drug effects*; D011603:Psychophysiology; D011788:Quality of Life; D057566:Self Report; D013629:Tamoxifen / Q000627:therapeutic use*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D013629:Tamoxifen