Tolga Bicer1, Goksen Inanc Imamoglu2, Aysun Sanal Dogan3, Nese Arslan Avarisli3, Naciye Kabatas3, Burcu Kucuk Bicer4, Canan Gurdal3. 1. Department of Ophthalmology, Saglik Bilimleri University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey. drtolgabicer@gmail.com. 2. Department of Medical Oncology, Saglik Bilimleri University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey. 3. Department of Ophthalmology, Saglik Bilimleri University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey. 4. Faculty of Medicine, Department of Medical Education and Informatics, Gazi University, Ankara, Turkey.
Abstract
PURPOSE: Aromatase inhibitors (anastrozole, letrozole) and selective estrogen receptor modulators (tamoxifen) are widely used as adjuvant hormonal therapy in women with hormone receptor-positive breast cancer. We aimed to evaluate the effects of oral adjuvant hormonotherapy on tear functions in patients with breast cancer. METHODS: In this case-control study, we enrolled eligible patients with breast cancer who were receiving regular medical selective estrogen receptor modulator (tamoxifen, n:50), aromatase inhibitors (anastrozole, letrozole, n:50) and gender-matched healthy controls (n:50). Tear functions were measured and compared by the Schirmer test, fluorescein breakup time, corneal staining evaluated by Oxford grading scale and Ocular Surface Disease Index scores. RESULTS: Mean age was 49.95 (± 9.2), 51.52 (± 7.2) and 51.91 (± 10.3) in tamoxifen, aromatase inhibitors groups and controls (p = 0.426). Mean duration of BC diagnosis (p = 0.536) and drug use (p = 0.417) was not significant between two groups. Ocular Surface Disease Index scores were lower (p < 0.001), and fluorescein breakup time measurements were higher (p < 0.001) in controls. Schirmer test scores were higher in controls than aromatase inhibitors group (p < 0.001). According to the scores of all measurements, the differences between aromatase inhibitors and tamoxifen groups were statistically significant (p < 0.001). CONCLUSIONS: Our results demonstrated a high difference in all parameters in patients receiving aromatase inhibitors compared to tamoxifen group and controls. Aromatase inhibitors, which reduce estrogen levels in the blood, might affect the tear functions more than tamoxifen, which affects as antiestrogenic on estrogen receptors.
PURPOSE: Aromatase inhibitors (anastrozole, letrozole) and selective estrogen receptor modulators (tamoxifen) are widely used as adjuvant hormonal therapy in women with hormone receptor-positive breast cancer. We aimed to evaluate the effects of oral adjuvant hormonotherapy on tear functions in patients with breast cancer. METHODS: In this case-control study, we enrolled eligible patients with breast cancer who were receiving regular medical selective estrogen receptor modulator (tamoxifen, n:50), aromatase inhibitors (anastrozole, letrozole, n:50) and gender-matched healthy controls (n:50). Tear functions were measured and compared by the Schirmer test, fluorescein breakup time, corneal staining evaluated by Oxford grading scale and Ocular Surface Disease Index scores. RESULTS: Mean age was 49.95 (± 9.2), 51.52 (± 7.2) and 51.91 (± 10.3) in tamoxifen, aromatase inhibitors groups and controls (p = 0.426). Mean duration of BC diagnosis (p = 0.536) and drug use (p = 0.417) was not significant between two groups. Ocular Surface Disease Index scores were lower (p < 0.001), and fluorescein breakup time measurements were higher (p < 0.001) in controls. Schirmer test scores were higher in controls than aromatase inhibitors group (p < 0.001). According to the scores of all measurements, the differences between aromatase inhibitors and tamoxifen groups were statistically significant (p < 0.001). CONCLUSIONS: Our results demonstrated a high difference in all parameters in patients receiving aromatase inhibitors compared to tamoxifen group and controls. Aromatase inhibitors, which reduce estrogen levels in the blood, might affect the tear functions more than tamoxifen, which affects as antiestrogenic on estrogen receptors.
Authors: Dragos Serban; Daniel Ovidiu Costea; Anca Zgura; Mihail Silviu Tudosie; Ana Maria Dascalu; Gabriel Andrei Gangura; Catalin Gabriel Smarandache; Alexandru Dan Sabau; Corneliu Tudor; Mihai Faur; Andreea Cristina Costea; Daniela Stana; Simona Andreea Balasescu; Laura Carina Tribus; Ciprian Tanasescu Journal: In Vivo Date: 2022 Jan-Feb Impact factor: 2.155