title: Interest in Integrative Medicine Among Postmenopausal Hormone Receptor-Positive Breast Cancer Patients in the EvAluate-TM Study.
abstract: Breast cancer patients often use complementary and alternative medicine, but few prospectively collected data on the topic are available specifically for postmenopausal breast cancer patients. A large prospective study was therefore conducted within a noninterventional study in order to identify the characteristics of patients interested in integrative medicine.
  
  
  
  The EvAluate-TM study is a prospective, multicenter noninterventional study in which treatment with the aromatase inhibitor letrozole was evaluated in postmenopausal women with hormone receptor-positive primary breast cancer. Between 2008 and 2009, 5045 postmenopausal patients were enrolled at 339 certified breast centers in Germany. As part of the data collection process, patients were asked at the baseline about their interest in and information needs relating to integrative medicine.
  
  
  
  Of the 5045 patients recruited, 3411 responded to the questionnaire on integrative medicine and took part in the analysis, 1583 patients expressed an interest in integrative medicine, and 1828 patients declared no interest. Relevant predictors of interest in integrative medicine were age, body mass index, tumor size, previous chemotherapy, and use of concomitant medications for other medical conditions. Interest in integrative medicine declined highly significantly ( P < .001) with age (<50 years, 74.1%; 50-60 years, 54.1%; >65 years, 38.0%). Patients in favor of integrative medicine were significantly less satisfied with the information received about individual treatments and antihormonal therapy. Patients with interest in integrative medicine were more often interested in rehabilitation and fitness, nutritional counseling, and additional support from self-help organizations. These women were mostly interested in receiving information about their disease and integrative medicine from a physician, rather than from other sources.
  
  
  
  This study shows that a considerable proportion of postmenopausal breast cancer patients are interested in integrative medicine. Information about integrative medicine should therefore be provided as part of patient care for this group. It was found that receiving concomitant medication for other medical conditions is one of the main predictors for women not being interested in integrative medicine. This group of patients may need special attention and individualized information about integrative medicine. Additionally, most patients were interested in obtaining the relevant information from their doctor.
authors.affiliation: 1 Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-European Metropolitan area Nuremberg (CCC ER-EMN), Germany.
authors.forename: Carolin C
authors.initials: CC
authors.lastname: Hack
authors.affiliation: 1 Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-European Metropolitan area Nuremberg (CCC ER-EMN), Germany.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Fasching
authors.affiliation: 2 Universitäts-Frauenklinik Düsseldorf, Düsseldorf, Germany.|3 Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard-Karls-Universität, Tübingen, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Fehm
authors.affiliation: 4 Frauenklinik im Klinikum Dachau, Dachau, Germany.
authors.forename: Johann
authors.initials: J
authors.lastname: de Waal
authors.affiliation: 5 Luisenkrankenhaus Düsseldorf, Düsseldorf, Germany.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Rezai
authors.affiliation: 4 Frauenklinik im Klinikum Dachau, Dachau, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Baier
authors.affiliation: 6 Onkologische Praxis Pinneberg, Pinneberg, Germany.
authors.forename: Gerold
authors.initials: G
authors.lastname: Baake
authors.affiliation: 7 Marienhospital Bottrop, Bottrop, Germany.
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Kolberg
authors.affiliation: 8 Klinikum Tuttlingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Guggenberger
authors.affiliation: 9 Brustzentrum, Universitäts-Frauenklinik, Cologne, Germany.|10 Brustzentrum, Klinken der Stadt Cologne gGmbH, Holweide, Germany.
authors.forename: Mathias
authors.initials: M
authors.lastname: Warm
authors.affiliation: 3 Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard-Karls-Universität, Tübingen, Germany.|11 Brustzentrum der Universität München, Frauenkliniken Grosshadern und Maistrasse, Munich, Germany.
authors.forename: Nadia
authors.initials: N
authors.lastname: Harbeck
authors.affiliation: 3 Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard-Karls-Universität, Tübingen, Germany.|11 Brustzentrum der Universität München, Frauenkliniken Grosshadern und Maistrasse, Munich, Germany.
authors.forename: Rachel
authors.initials: R
authors.lastname: Wuerstlein
authors.affiliation: 12 Vinzenzkrankenhaus Hanover gGmbH, Hanover, Germany.
authors.forename: Jörg-Uwe
authors.initials: JU
authors.lastname: Deuker
authors.affiliation: 13 Frauenklinik, Städtisches Klinikum Lüneburg, Lüneburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Dall
authors.affiliation: 14 Elblandkliniken Meissen-Radebeul, Radebeul, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Richter
authors.affiliation: 15 Kreiskrankenhaus Böblingen, Böblingen, Germany.
authors.forename: Grischa
authors.initials: G
authors.lastname: Wachsmann
authors.affiliation: 16 Universitätsklinik für Frauenheilkunde, Paracelsus Medizinische Privatuniversität, Nuremberg, Germany.
authors.forename: Cosima
authors.initials: C
authors.lastname: Brucker
authors.affiliation: 17 Frauenklinik der St. Josefsklinik, Offenburg, Germany.
authors.forename: Jan W
authors.initials: JW
authors.lastname: Siebers
authors.affiliation: 18 Frauenklinik, Klinikum Bayreuth GmbH, CCC ER-EMN, Bayreuth, Germany.
authors.forename: Nikos
authors.initials: N
authors.lastname: Fersis
authors.affiliation: 19 Karl-Olga-Krankenhaus, Stuttgart, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kuhn
authors.affiliation: 20 Medizinisches Zentrum Ulm, Ulm, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Wolf
authors.affiliation: 21 Klinikum Friedrichshafen, Friedrichshafen, Germany.
authors.forename: Hans-Walter
authors.initials: HW
authors.lastname: Vollert
authors.affiliation: 22 Städtisches Klinikum Neunkirchen Gynäkologie und Geburtshilfe, Neunkirchen, Germany.
authors.forename: Georg-Peter
authors.initials: GP
authors.lastname: Breitbach
authors.affiliation: 23 Frauenklinik des Universitätsklinikums Ulm, Ulm, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Janni
authors.affiliation: 24 Gynäkologische Praxis in der Kreisklinik Krumbach, Krumbach, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Landthaler
authors.affiliation: 25 Evangelisches Krankenhaus Ludwigsfelde-Teltow, Ludwigsfelde, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kohls
authors.affiliation: 26 Marien-Hospital Wesel, Wesel, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Rezek
authors.affiliation: 27 Frauenklinik am Kreiskrankenhaus Hameln, Hameln, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Noesslet
authors.affiliation: 28 Landkreis Mittweida Krankenhaus gGmbH, Mittweida, Germany.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Fischer
authors.affiliation: 29 Johanniter Krankenhaus Genthin Stendal gGmbH, Stendal, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Henschen
authors.affiliation: 30 Caritas-Krankenhaus, Bad Mergentheim, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Praetz
authors.affiliation: 31 Asklepios Paulinen Klinik, Wiesbaden, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Heyl
authors.affiliation: 32 Frauenklinik, Städtische Kliniken, Esslingen am Neckar, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Kühn
authors.affiliation: 33 Frauenklinik Lippe-Detmold, Detmold, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Krauss
authors.affiliation: 34 Frauenklinik, Martin Luther University, Halle-Wittenberg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Thomssen
authors.affiliation: 35 Kreiskrankenhaus Rendsburg, Rendsburg, Germany.
authors.forename: Andre
authors.initials: A
authors.lastname: Hohn
authors.affiliation: 36 Onkologie Bethanien Frankfurt, Frankfurt, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Tesch
authors.affiliation: 37 Frauenklinik, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Mundhenke
authors.affiliation: 1 Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-European Metropolitan area Nuremberg (CCC ER-EMN), Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hein
authors.affiliation: 1 Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-European Metropolitan area Nuremberg (CCC ER-EMN), Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Rauh
authors.affiliation: 1 Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-European Metropolitan area Nuremberg (CCC ER-EMN), Germany.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Bayer
authors.affiliation: 38 Novartis Pharma GmbH, Nuremberg, Germany.
authors.forename: Adib
authors.initials: A
authors.lastname: Jacob
authors.affiliation: 38 Novartis Pharma GmbH, Nuremberg, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Schmidt
authors.affiliation: 39 Clin-Sol GmbH, Würzburg, Germany.
authors.forename: Erik
authors.initials: E
authors.lastname: Belleville
authors.affiliation: 40 Krankenhaus Nordwest, Klinik für Gynäkologie und Geburtshilfe, Frankfurt, Germany.
authors.forename: Peyman
authors.initials: P
authors.lastname: Hadji
authors.affiliation: 3 Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard-Karls-Universität, Tübingen, Germany.
authors.forename: Sara Y
authors.initials: SY
authors.lastname: Brucker
authors.affiliation: 3 Department für Frauengesundheit, Universitätsklinikum Tübingen, Eberhard-Karls-Universität, Tübingen, Germany.
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.affiliation: 41 Brustzentrum, Kliniken Essen Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany.
authors.forename: Sherko
authors.initials: S
authors.lastname: Kümmel
authors.affiliation: 1 Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-European Metropolitan area Nuremberg (CCC ER-EMN), Germany.
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.affiliation: 42 Frauenklinik rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Paepke
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D005858:Germany; D006801:Humans; D055048:Integrative Medicine / Q000379:methods; D000077289:Letrozole; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use*; D017698:Postmenopause / Q000187:drug effects*; D011446:Prospective Studies; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole
keywords: aromatase inhibitor; breast cancer; complementary and alternative medicine; information; integrative medicine; letrozole; oncology; therapy management