Journal scan

Negative changes in menopausal-specific QoL linked to stopping chemoprevention therapy

Breast cancer is the most commonly occurring female cancer globally and represents a significant cause of death due to malignant disease. For people predisposed to developing the disease, primary prevention represents an important intervention for minimising risk. However, this approach tends to be in clinical practice and, when it is used, is often associated with issues of nonadherence.

This Canadian paper describes a study examining the impact of adverse changes in menopausal associated quality of life (MENQoL) and the accordance and compliance with endocrine-based chemoprevention treatment.

The study completed secondary analysis of the Canadian Cancer Trials group mammary prevention 3 data. This was a phase-three international, randomised, placebo-controlled trial assessing the utility of exemestane, a steroidal aromatase inhibitor, which is linked with

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Breast cancer is the most commonly occurring female cancer globally and represents a significant cause of death due to malignant disease. For people predisposed to developing the disease, primary prevention represents an important intervention for minimising risk. However, this approach tends to be in clinical practice and, when it is used, is often associated with issues of nonadherence.


A decline in general menopausal associated quality of life was the strongest factor associated with cessation of treatment, the study found.  Photo: iStock

This Canadian paper describes a study examining the impact of adverse changes in menopausal associated quality of life (MENQoL) and the accordance and compliance with endocrine-based chemoprevention treatment.

The study completed secondary analysis of the Canadian Cancer Trials group mammary prevention 3 data. This was a phase-three international, randomised, placebo-controlled trial assessing the utility of exemestane, a steroidal aromatase inhibitor, which is linked with clinically consequential effects.

Data from more than 4,500 women was analysed. The women in the sample experienced a deterioration in sexual, psychosocial, physical, and vasomotor domains of QoL (19%, 27%, 28% and 35% respectively). A decline in the general MENQoL was the strongest factor associated with cessation of treatment, irrespective of whether the participant received exemestane or not. However, those allotted to the drug arm of the study were 59% more likely to terminate treatment.

Meggetto O, Maunsell E, Chlebowski R et al (2017) Factors associated with early discontinuation of study treatment in the mammary prevention.3 breast cancer chemoprevention trial. Journal of Clinical Oncology. 35, 6, 629-635.

Journal scan is ​compiled by Dion Smyth, lecturer-practitioner in cancer and palliative care, Birmingham City University

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