Skip to main content

Advertisement

SpringerLink
Log in

Joint symptoms and health-related quality of life in postmenopausal women with breast cancer who completed 5 years of anastrozole

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

To assess the joint symptoms and the impact on patients’ health-related quality of life (HRQOL) due to 5 years of anastrozole from the baseline data in the N-SAS BC 05 trial, a randomized clinical trial was designed to assess the efficacy of 5 additional years of anastrozole among women with breast cancer.

Methods

Joint symptoms and HRQOL were evaluated using an original questionnaire for joint symptoms, the Short Form 36-item Health Survey (SF-36), the EuroQol EQ-5D-3L, and a subscale of the Functional Assessment of Cancer Therapy-Endocrine Symptoms (FACT-ES).

Results

Baseline joint symptom and HRQOL data were collected from 330 patients between November 2007 and March 2010. Joint pain and joint stiffness were reported by 61.6 and 59.1 % of patients, respectively, although these symptoms did not affect the activities of daily living in 96.0 and 97.9 % of patients, respectively. Joint pain was reported in the knee by 61.0 % of patients and in the hand by 36.0 % of patients. Joint stiffness mainly affected the hand (67.9 %), especially the proximal interphalangeal joint, and typically occurred upon waking up or in the morning. Most SF-36 domains had good average scores, although slight decreases in physical functioning and role-physical were observed (compared to the national standard scores). The mean EQ-5D utility score was 0.86, and the total FACT-ES subscale score was 62.2/76.

Conclusions

After 5 years of anastrozole, many of the patients reported joint pain and stiffness in mainly the hand and knee with mild symptoms and good HRQOL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Coombes RC, Hall E, Gibson LJ, et al (2004) A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer. N Engl J Med 350:1081–1092

    Article  PubMed  CAS  Google Scholar 

  2. Arimidex, Tamoxifen, Alone or in Combination (ATAC) Trialists’ Group, Forbes JF, Cuzick J, Buzdar A, Howell A, Tobias JS, Baum M (2008) Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 100-month analysis of the ATAC trial. Lancet Oncol 9:45–53

    Article  CAS  Google Scholar 

  3. Regan MM, Neven P, Giobbie-Hurder A, et al (2011) Assessment of letrozole and tamoxifen alone and in sequence for postmenopausal women with steroid hormone receptor-positive breast cancer: the BIG 1-98 randomised clinical trial at 8·1 years median follow-up. Lancet Oncol 12:1101–1108

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Mouridsen HT (2006) Incidence and management of side effects associated with aromatase inhibitors in the adjuvant treatment of breast cancer in postmenopausal women. Curr Med Res Opin 22:1609–1621

    Article  PubMed  CAS  Google Scholar 

  5. Howell A, Cuzick J, Baum M, Buzdar A, Dowsett M, Forbes JF, Hoctin-Boes G, Houghton J, Locker GY, Tobias JS, ATAC Trialists’ Group (2005) Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet 365:60–62

    Article  PubMed  CAS  Google Scholar 

  6. Arimidex, Tamoxifen, Alone or in Combination Trialists’ Group, Buzdar A, Howell A, et al (2006) Comprehensive side-effect profile of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: long-term safety analysis of the ATAC trial. Lancet Oncol 7:633–643

    Article  PubMed  CAS  Google Scholar 

  7. Crew KD, Greenlee H, Capodice J, et al (2007) Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer. J Clin Oncol 25:3877–3883

    Article  PubMed  Google Scholar 

  8. Henry NL, Azzouz F, Desta Z, et al (2012) Predictors of aromatase inhibitor discontinuation as a result of treatment-emergent symptoms in early-stage breast cancer. J Clin Oncol 30:936–942

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. Chim K, Xie SX, Stricker CT, et al (2013) Joint pain severity predicts premature discontinuation of aromatase inhibitors in breast cancer survivors. BMC Cancer 13:401

    Article  PubMed  PubMed Central  Google Scholar 

  10. 1998) Tamoxifen for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collab Group Lancet 351:1451–1467

  11. Ohsumi S, Shimozuma K (2013) Current status and future perspectives of patient-reported outcome research in clinical trials for patients with breast cancer in Japan. Breast Cancer 20:296–301

    Article  PubMed  Google Scholar 

  12. Ware JE, Jr SF-36 Health Survey Update. http://www.sf-36org/tools/sf36s.html.

  13. McHorney CA, Ware Jr JE, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263

    Article  PubMed  CAS  Google Scholar 

  14. Fukuhara S, Ware Jr JE, Kosinski M, Wada S, Gandek B (1998) Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol 51:1045–1053

    Article  PubMed  CAS  Google Scholar 

  15. Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K (1998) Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 51:1037–1044

    Article  PubMed  CAS  Google Scholar 

  16. EQ-5D-3L. http://www.euroqolorg/eq-5d-products/eq-5d-3l.html.

  17. EuroQol Group (1990) EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 16:199–208

    Article  Google Scholar 

  18. Tsuchiya A, Ikeda S, Ikegami N, et al (2002) Estimating an EQ-5D population value set: the case of Japan. Health Econ 11:341–353

    Article  PubMed  Google Scholar 

  19. Fallowfield LJ, Leaity SK, Howell A, Benson S, Cella D (1999) Assessment of quality of life in women undergoing hormonal therapy for breast cancer: validation of an endocrine symptom subscale for the FACT-B. Breast Cancer Res Treat 55:189–199

    Article  PubMed  CAS  Google Scholar 

  20. Aaronson NK, Ahmedzai S, Bergman B, et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  PubMed  CAS  Google Scholar 

  21. Cella DF, Tulsky DS, Gray G, et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579

    PubMed  CAS  Google Scholar 

  22. Kurihara M, Shimizu H, Tsuboi K, et al (1999) Development of quality of life questionnaire in Japan: quality of life assessment of cancer patients receiving chemotherapy. Psychooncology 8:355–563

    Article  PubMed  CAS  Google Scholar 

  23. Shimozuma K, Ohashi Y, Takeuchi A, et al (2009) Feasibility and validity of the Patient Neurotoxicity Questionnaire during taxane chemotherapy in a phase III randomized trial in patients with breast cancer: N-SAS BC 02. Support Care Cancer 17:1483–1491

    Article  PubMed  Google Scholar 

  24. Shiroiwa T, Fukuda T, Shimozuma K, et al (2011) Comparison of EQ-5D scores among anthracycline-containing regimens followed by taxane and taxane-only regimens for node-positive breast cancer patients after surgery: the N-SAS BC 02 trial. Value Health 14:746–751

    Article  PubMed  Google Scholar 

  25. Velikova G, Wright P, Smith AB, et al (2001) Self-reported quality of life of individual cancer patients: concordance of results with disease course and medical records. J Clin Oncol 19:2064–2073

    PubMed  CAS  Google Scholar 

  26. Fromme EK, Eilers KM, Mori M, Hsieh YC, Beer TM (2004) How accurate is clinician reporting of chemotherapy adverse effects? A comparison with patient-reported symptoms from the Quality-of-Life Questionnaire C30. J Clin Oncol 22:3485–3490

    Article  PubMed  Google Scholar 

  27. Ruhstaller T, von Moos R, Rufibach K, et al (2009) Breast cancer patients on endocrine therapy reveal more symptoms when self-reporting than in pivotal trials: an outcome research study. Oncology 76:142–148

    Article  PubMed  Google Scholar 

  28. Mao JJ, Stricker C, Bruner D, et al (2009) Patterns and risk factors associated with aromatase inhibitor-related arthralgia among breast cancer survivors. Cancer 115:3631–3639

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  29. Pickard AS, Wilke CT, Lin HW, Lloyd A (2007) Health utilities using the EQ-5D in studies of cancer. PharmacoEconomics 25:365–384

    Article  PubMed  Google Scholar 

  30. Cella D, Fallowfield L, Barker P, Cuzick J, Locker G, Howell A (2006) 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. Breast Cancer Res Treat 100:273–284

    Article  PubMed  Google Scholar 

  31. Whelan TJ, Goss PE, Ingle JN, et al (2005) Assessment of quality of life in MA.17: a randomized, placebo-controlled trial of letrozole after 5 years of tamoxifen in postmenopausal women. J Clin Oncol 23:6931–6940

    Article  PubMed  CAS  Google Scholar 

  32. Muss HB, Tu D, Ingle JN, et al (2008) Efficacy, toxicity, and quality of life in older women with early-stage breast cancer treated with letrozole or placebo after 5 years of tamoxifen: NCIC CTG Intergroup Trial MA.17. J Clin Oncol 26:1956–1964

    Article  PubMed  CAS  Google Scholar 

  33. Davies C, Pan H, Godwin J, et al (2013) Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet 381:805–816

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  34. Higgins MJ, Liedke PE, Goss PE (2013) Extended adjuvant endocrine therapy in hormone dependent breast cancer: the paradigm of the NCIC-CTG MA.17/BIG 1-97 trial. Crit Rev Oncol Hematol 86:23–32

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the Comprehensive Support Project for Oncology Research (CSP-OR) and the Comprehensive Support Project for Health Outcomes Research (CSP-HOR) of the Public Health Research Foundation. The corporate and individual sponsors of this study are listed on the CSP-OR website (http://www.csp.or.jp/cspor/kyousan_e.html). The pharmaceutical manufacturer/distributor played no role in this study, except in providing information regarding the proper use of the study drugs. All decisions concerning the planning, implementation, and publication of this study were made exclusively by the executive committee. We would like to thank Editage (www.editage.jp) for the English language editing.

Disclosures

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Department of Breast Care, Saitama Medical Center, Saitama Medical University, 1981, Kamoda, Kawagoe-shi, Saitama, 350-0844, Japan

    Hiroshi Yagata

  2. Leading Center for the Development and Research of Cancer Medicine, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-Ku, Tokyo, 113-8421, Japan

    Hiroshi Ohtsu

  3. Department of Surgery, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Yoshifumi Komoike

  4. Department of Medical Oncology, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan

    Shigehira Saji

  5. Department of Breast Oncology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyou-ku, Tokyo, 113-8603, Japan

    Hiroyuki Takei

  6. National Center for Global Health and Medicine Center Hospital, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Toshitaka Nakamura

  7. Department of Integrated Science and Engineering for Sustainable Society, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo, 112-8511, Japan

    Yasuo Ohashi

  8. Department of Breast Surgery, Cancer Institute Hospital, 3-8-31 Ariake, Koto, Tokyo, 135-8550, Japan

    Takuya Iwase

  9. Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, 1-1-1, Noji-Higashi, Kusatsu, 525-8577, Japan

    Kojiro Shimozuma

Authors
  1. Hiroshi Yagata
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroshi Ohtsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshifumi Komoike
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shigehira Saji
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hiroyuki Takei
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Toshitaka Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yasuo Ohashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takuya Iwase
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kojiro Shimozuma
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroshi Yagata.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOC 2.44 mb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yagata, H., Ohtsu, H., Komoike, Y. et al. Joint symptoms and health-related quality of life in postmenopausal women with breast cancer who completed 5 years of anastrozole. Support Care Cancer 24, 683–689 (2016). https://doi.org/10.1007/s00520-015-2830-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-015-2830-6

Keywords

Search

Navigation