OBJECTIVES: A literature search was conducted to gather information concerning the pathophysiologic mechanisms leading to hot flushes, their prevalence and severity in breast cancer patients, their influence on quality of life, and the best therapeutic option. METHODS: Relevant studies in English were selected from Medline. RESULTS AND CONCLUSION: Pathophysiologic mechanisms leading to hot flushes are poorly understood. Estrogen withdrawal is considered to have a central role. Also, serotonin and norepinephrine seem to be involved in hot flush induction. Menopause induced by chemotherapy or ovarian ablation, is accompanied by an abrupt decrease in estrogen level, causing vasomotor symptoms. Hot flushes are also a side effect of tamoxifen and aromatase inhibitors. Quality of life in breast cancer patients may be negatively influenced by hot flushes, and therefore, adequate treatment is important. Currently, of the several non-hormonal options, the selective serotonin-reuptake inhibitor (SSRI) venlafaxine is the most effective in breast cancer patients. However, studies on interaction between SSRIs and tamoxifen may influence future recommendations.
OBJECTIVES: A literature search was conducted to gather information concerning the pathophysiologic mechanisms leading to hot flushes, their prevalence and severity in breast cancerpatients, their influence on quality of life, and the best therapeutic option. METHODS: Relevant studies in English were selected from Medline. RESULTS AND CONCLUSION: Pathophysiologic mechanisms leading to hot flushes are poorly understood. Estrogen withdrawal is considered to have a central role. Also, serotonin and norepinephrine seem to be involved in hot flush induction. Menopause induced by chemotherapy or ovarian ablation, is accompanied by an abrupt decrease in estrogen level, causing vasomotor symptoms. Hot flushes are also a side effect of tamoxifen and aromatase inhibitors. Quality of life in breast cancerpatients may be negatively influenced by hot flushes, and therefore, adequate treatment is important. Currently, of the several non-hormonal options, the selective serotonin-reuptake inhibitor (SSRI) venlafaxine is the most effective in breast cancerpatients. However, studies on interaction between SSRIs and tamoxifen may influence future recommendations.
Authors: Ellen B Gold; John P Pierce; Loki Natarajan; Marcia L Stefanick; Gail A Laughlin; Bette J Caan; Shirley W Flatt; Jennifer A Emond; Nazmus Saquib; Lisa Madlensky; Sheila Kealey; Linda Wasserman; Cynthia A Thomson; Cheryl L Rock; Barbara A Parker; Njeri Karanja; Vicky Jones; Richard A Hajek; Minya Pu; Joanne E Mortimer Journal: J Clin Oncol Date: 2008-12-15 Impact factor: 44.544
Authors: Reina Haque; Jiaxiao Shi; Joanne E Schottinger; Syed A Ahmed; T Craig Cheetham; Joanie Chung; Chantal Avila; Ken Kleinman; Laurel A Habel; Suzanne W Fletcher; Marilyn L Kwan Journal: J Natl Cancer Inst Date: 2015-12-01 Impact factor: 13.506