title: Adjuvant endocrine therapy in women with oestrogen-receptor-positive breast cancer: how should the skeletal and vascular side effects be assessed and managed?
abstract: Adjuvant endocrine therapy provides oncological benefits in women with early oestrogen-receptor-positive breast cancer, but has adverse effects consequent to induced oestradiol deficiency. Bone loss is accelerated, predisposing to increased fracture risk. Metabolic effects include changes in lipid metabolism and body composition although effects on cardiovascular risk are still unclear. Women commencing endocrine therapy should be proactively counselled about and monitored for these and other therapy-related complications including arthralgia and vasomotor symptoms. We provide strategies for prevention and management of these adverse effects, based, where available, on randomized controlled trial evidence specific to breast cancer survivors receiving endocrine treatment.
authors: Deparment of Endocrinology, Austin Health, Melbourne, Vic., Australia.|Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Vic., Australia.
authors: Sabashini K
authors: SK
authors: Ramchand
authors: Cancer Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.|The Kinghorn Cancer Centre, St Vincent's Hospital, Darlinghurst, NSW, Australia.
authors: Elgene
authors: E
authors: Lim
authors: Deparment of Endocrinology, Austin Health, Melbourne, Vic., Australia. mathisg@unimelb.edu.au.|Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Vic., Australia. mathisg@unimelb.edu.au.
authors: Mathis
authors: M
authors: Grossmann
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D001823:Body Composition; D001862:Bone Resorption / Q000209:etiology / Q000517:prevention & control; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods*; D019468:Disease Management; D004958:Estradiol / Q000172:deficiency; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D011960:Receptors, Estrogen
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011960:Receptors, Estrogen; D004958:Estradiol