Predictors of vasomotor symptoms among breast cancer survivors
Vasomotor symptoms (VMS) are a common side effect of breast cancer treatment, yet modifiable factors that may predict VMS among breast cancer survivors are unknown.
We estimated multivariable-adjusted odds ratios and 95% confidence intervals (aOR, 95% CI) for predictors of VMS among 3595 breast cancer survivors enrolled in the Life and Longevity after Cancer (LILAC) study, an ancillary study of the Women’s Health Initiative (WHI).
VMS post-diagnosis were reported by 790 (22.0%) participants. Risk of VMS after diagnosis was positively associated with prior chemotherapy (aOR 1.80, 95% CI 1.21–2.68) and adjuvant hormone therapy (aOR 2.73, 95% CI 2.08–3.58), postmenopausal hormone therapy use (aOR 1.67, 95% CI 1.30–2.13), prior VMS (aOR 2.20, 95% CI 1.73–2.80), bilateral oophorectomy (aOR 1.77, 95% CI 1.37–2.27), and baseline antidepressant use (aOR 1.49, 1.06–2.09). VMS post-diagnosis were less likely among younger women (aOR 0.94, 95% CI 0.93–0.96), women younger at menopause (aOR 0.98, 95% CI 0.97–1.00), women with more time since diagnosis (aOR 0.92, 95% CI 0.90–0.94), and diabetics (aOR 0.45, 95% CI 0.21–0.95). Metabolic syndrome was not associated with post-diagnosis VMS (aOR 0.76, 95% CI 0.45–1.28).
VMS following breast cancer diagnosis was related to a number of modifiable factors, but was unrelated to metabolic syndrome.
Implications for Cancer Survivors
Identification of factors that predispose women to VMS following a breast cancer diagnosis may allow clinicians to recognize and address VMS in the subset of women who are most likely to experience such symptoms.
KeywordsBreast cancer Vasomotor symptoms Metabolic syndrome Treatment
Program Office: (National Heart, Lung, and Blood Institute, Bethesda, Maryland) Jacques
Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, and Nancy Geller
Clinical Coordinating Center: (Fred Hutchinson Cancer Research Center, Seattle, WA) Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg
Investigators and Academic Centers: (Brigham and Women’s Hospital, Harvard Medical School, Boston, MA) JoAnn E. Manson; (MedStar Health Research Institute/Howard University, Washington, DC) Barbara V. Howard; (Stanford Prevention Research Center, Stanford, CA) Marcia L. Stefanick; (The Ohio State University, Columbus, OH) Rebecca Jackson; (University of Arizona, Tucson/Phoenix, AZ) Cynthia A. Thomson; (University at Buffalo, Buffalo, NY) Jean Wactawski-Wende; (University of Florida, Gainesville/Jacksonville, FL) Marian Limacher; (University of Iowa, Iowa City/Davenport, IA) Jennifer Robinson; (University of Pittsburgh, Pittsburgh, PA) Lewis Kuller; (Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker; (University of Nevada, Reno, NV) Robert Brunner; (University of Minnesota, Minneapolis, MN) Karen L. Margolis
The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, and U.S. Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HSN268201100003C, HHSN268201100004C, and HHSN271201100004C. The LILAC study is funded by the National Cancer Institute (UM1CA173642).
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
Conflict of interest
The authors have no conflicts of interest to disclose.
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