Quality of Life of Postmenopausal Women in the ATAC (“Arimidex”, Tamoxifen, Alone or in Combination) Trial after Completion of 5 years' Adjuvant Treatment for Early Breast Cancer

  title={Quality of Life of Postmenopausal Women in the ATAC (“Arimidex”, Tamoxifen, Alone or in Combination) Trial after Completion of 5 years' Adjuvant Treatment for Early Breast Cancer},
  author={David Cella and Lesley Fallowfield and Peter N Barker and Jack M Cuzick and Gershon Y Locker and Anthony Howell and On behalf of The Norwegian Rectal Cancer Group},
  journal={Breast Cancer Research and Treatment},
The impact of treatment on health-related quality of life (HRQoL) is an important consideration in the adjuvant treatment of operable breast cancer. Here we report mature HRQoL outcomes from the ATAC trial, comparing anastrozole with tamoxifen as primary adjuvant therapy for postmenopausal women with localized breast cancer. Patients completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire plus endocrine subscale (ES) at baseline, 3 and 6 months, and every 6 months… 

Health-related quality of life of postmenopausal Chinese women with hormone receptor-positive early breast cancer during treatment with adjuvant aromatase inhibitors: a prospective, multicenter, non-interventional study

Improved long-term QoL in postmenopausal Chinese patients with HR+ EBC with AI adjuvant treatment is indicated, which will aid clinicians in optimizing treatment to yield effective healthcare outcomes.

Longitudinal Effects of Adjuvant Endocrine Therapy on the Quality of Life of Post-menopausal Women with Non-metastatic ER+ Breast Cancer: A Systematic Review

It is suggested that the QOL of post-menopausal women is unlikely to be adversely affected by long-term use of adjuvant endocrine therapy, and efforts are needed to improve the quality of QOL reporting in clinical trials.

Health-related quality of life and psychological distress of breast cancer patients after surgery during a phase III randomized trial comparing continuation of tamoxifen with switching to anastrozole after adjuvant tamoxifen for 1–4 years: N-SAS BC 03

Continuation of tamoxIFen treatment after adjuvant tamoxifen for 1–4 years may provide Japanese breast cancer patients with better HRQOL than by switching to anastrozole, and there was no statistically significant difference between the treatment groups in the CES-D scores.

Comparison of menopausal symptoms during the first year of adjuvant therapy with either exemestane or tamoxifen in early breast cancer: report of a Tamoxifen Exemestane Adjuvant Multicenter trial substudy.

At 12 months, exemestane was associated with fewer hot flashes and less vaginal discharge than tamoxifen, but with more vaginal dryness, bone/muscle aches, and difficulty sleeping.

Health-related quality of life and psychological distress during neoadjuvant endocrine therapy with letrozole to determine endocrine responsiveness in postmenopausal breast cancer

Neoadjuvant endocrine therapy with LET had no impact on global HRQoL, but did influence endocrine-related symptoms such as hot flush, and the number of patients with clinically significant hot flush increased significantly.

Health-related quality of life, psychological distress, and adverse events in postmenopausal women with breast cancer who receive tamoxifen, exemestane, or anastrozole as adjuvant endocrine therapy: National Surgical Adjuvant Study of Breast Cancer 04 (N-SAS BC 04)

Given the results of the TEAM trial, upfront use of tamoxifen followed by an aromatase inhibitor (AI) may be an important option for adjuvant endocrine therapy in Japanese postmenopausal women.

Assessment of Quality of Life in Postmenopausal Women with Early Breast Cancer Participating in the PACT Trial: The Impact of Additional Patient Information Material Packages and Patient Compliance.

Compliant patients appear to experience improved QoL compared to noncompliant patients, perhaps indicating a more self-empowered perception of their condition, and results should be interpreted carefully due to limitations in the statistical analyses.

Long-term assessment of quality of life in the Intergroup Exemestane Study: 5 years post-randomisation

Clinical benefits of switching to exemestane are accompanied by good overall QoL, and although some symptoms persist, the majority of endocrine symptoms improve after treatment completion.

Quality of life under extended continuous versus intermittent adjuvant letrozole in lymph node-positive, early breast cancer patients: the SOLE randomised phase 3 trial

Less symptom worsening was observed during the first year of extended treatment with the intermittent administration of intermittent letrozole, suggesting an intermittent administration is a safe alternative for women experiencing an increased symptom burden of extended adjuvant endocrine therapy.

The impact of adjuvant endocrine therapy in early breast cancer on quality-of-life: an overview of prospective trials

The aim of this present review is to report the results of prospective trials that have measured the effect of adjuvant ET on the quality-of-life (QOL) in breast cancer patients and find that the average change of QOL scores, if present, was unexpectedly small.



Quality of life in the intergroup exemestane study: a randomized trial of exemestane versus continued tamoxifen after 2 to 3 years of tamoxifen in postmenopausal women with primary breast cancer.

  • L. FallowfieldJ. Bliss E. Hall
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2006
Results indicate that the clinical benefits of exemestane over tamoxifen are achieved without significant detrimental effect on QOL, and no clinically meaningful differences found between groups in TOI or ES.

A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer.

Exemestane therapy after two to three years ofTamoxifen therapy significantly improved disease-free survival as compared with the standard five years of tamoxIFen treatment.

Assessment of quality of life in MA.17: a randomized, placebo-controlled trial of letrozole after 5 years of tamoxifen in postmenopausal women.

  • T. WhelanP. Goss H. Muss
  • Medicine, Psychology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2005
Letrozole did not have an adverse impact on overall QOL and small effects were seen in some domains consistent with a minority of patients experiencing changes in QOL compatible with a reduction in estrogen synthesis.

Assessment of quality of life in women undergoing hormonal therapy for breast cancer: validation of an endocrine symptom subscale for the FACT‐B

The development and validation of an 18 item endocrine subscale (ES) to accompany a standardised breast cancer quality of life measure, the Functional Assessment of Cancer Therapy (FACT‐B), has acceptable validity and reliability and is sensitive to clinically significant change, making it suitable for clinical trials of endocrine therapy.

Adjuvant tamoxifen: predictors of use, side effects, and discontinuation in older women.

Patients who were estrogen receptor-positive, had stage II disease, saw a greater number of breast cancer physicians, and had better perceptions of their abilities to discuss treatment options with physicians had greater odds of tamoxifen use.

Aromatase inhibitors in prevention--data from the ATAC (arimidex, tamoxifen alone or in combination) trial and the design of IBIS-II (the second International Breast Cancer Intervention Study).

  • J. Cuzick
  • Medicine
    Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer
  • 2003
Data from the ATAC adjuvant trial indicate that the aromatase inhibitor anastrozole is more effective than tamoxifen in reducing recurrence and preventing new contralateral tumours, and also has a more favourable side-effect profile.

American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer: status report 2004.

  • E. WinerC. Hudis M. Somerfield
  • Medicine, Biology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2005
It is believed that optimal adjuvant hormonal therapy for a postmenopausal woman with receptor-positive breast cancer includes an aromatase inhibitor as initial therapy or after treatment with tamoxifen.