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Body mass index and menopausal disorders during menopause affect vasomotor symptoms of postmenopausal Japanese breast cancer patients treated with anastrozole: a prospective multicenter cohort study of patient-reported outcomes

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Abstract

Background

Adverse events related to endocrine therapies have a major impact not only on patients’ quality of life but also on treatment discontinuation. Although vasomotor symptoms induced by aromatase inhibitors are frequently recognized, risk factors, especially for Japanese women, are not well reported. To identify risk factors for vasomotor symptoms of Japanese breast cancer patients treated with adjuvant anastrozole, we conducted a prospective cohort study based on patient-reported outcomes (PROs).

Patients and methods

For this prospective cohort study (SAVS-JP, UMIN000002455), 391 postmenopausal Japanese estrogen receptor-positive breast cancer patients who were treated with adjuvant anastrozole were recruited from 28 centers. The PRO assessment was obtained from a self-reported questionnaire at baseline, 3, 6, 9 and 12 months between August 2009 and April 2012. Vasomotor symptoms, comprising hot flashes, night sweats, and cold sweats, were categorized into four grades (none, Grade 1: mild, Grade 2: moderate, Grade 3: severe). Pre-existing symptoms were only included if they had become worse than at baseline.

Results

Hot flashes, night sweats, and cold sweats at baseline were reported by 20.5, 15.1, and 8.2 % of the patients, respectively, and new appearance or worsening of symptoms in comparison with baseline by 38.4, 29.3, and 28.7 %, respectively. About 80 % of newly occurring symptoms were Grade 1, and less than 5 % were Grade 3. Vasomotor symptoms were reported by 201 out of 362 patients (55.5 %) during the first year and the mean time to onset was 5.6 months. Patients with vasomotor symptoms were significantly younger (mean 62.8 years, range 38–86 vs 64.7 years, range 37–84; p = 0.02), had higher body mass index (BMI) (23.4 kg/m2, range 15.8–39.9 vs 22.4 kg/m2, range 15.8–34.9; p = 0.01), had vasomotor symptoms sooner after menopause (12.4 years, range 0–51 vs 15.1 years, range 1–37; p = 0.002), and had more menopausal disorders during menopause (63.3 vs 36.7 %; p = 0.002). Multivariate analysis showed that BMI [odds ratio (OR) 1.09 per unit of increase, 95 % confidence interval (CI) 1.02–1.16; p = 0.009] and experiencing menopausal disorders (OR 2.11, 95 % CI 1.35–3.30; p = 0.001) were significantly associated with vasomotor symptoms.

Conclusion

High BMI and experiencing menopausal disorders at menopause were found to be significantly associated with the occurrence of vasomotor symptoms. These findings are expected to prove useful for the management of postmenopausal Japanese women treated with aromatase inhibitors.

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Authors and Affiliations

  1. Department of Breast Surgery, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan

    Kaori Tane & Shintaro Takao

  2. Department of Surgery, Kansai Rosai Hospital, 3-1-69 Inaba-so, Amagasaki, Hyogo, 660-8511, Japan

    Chiyomi Egawa

  3. Department of Breast Surgery, Shinko Hospital, 1-4-47 Wakinohama-cho, Chuo-ku, Kobe, Hyogo, 651-0072, Japan

    Kazuhiko Yamagami

  4. Department of Surgery, Kohnan Hospital, 1-5-16 Kamokogahara, Higashinada-ku, Kobe, Hyogo, 658-0064, Japan

    Masaru Miyashita

  5. Department of Surgery, Itami City Hospital, 1-100 Koyaike, Itami, Hyogo, 664-8540, Japan

    Masashi Baba

  6. Rokko Island Hospital, 2-11 Koyochonaka, Higashinada-ku, Kobe, Hyogo, 658-0032, Japan

    Shigetoshi Ichii

  7. Department of Surgery, Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokutanji-cho, Nishinomiya, Hyogo, 662-0918, Japan

    Muneharu Konishi

  8. Department of Surgery, Kobe City Hospital Organization Kobe City Medical Center West Hospital, 2-4 Ichiban-cho, Nagata-ku, Kobe, Hyogo, 653-0013, Japan

    Yuichiro Kikawa

  9. Department of Surgery, Kobe Kyodo Hospital, 2-4-7 Kubo-cho, Nagata-ku, Kobe, Hyogo, 653-0041, Japan

    Junya Minohata

  10. Nishi-kobe Medical Center, 5-7-1 Kojidai, Nishi-ku, Kobe, Hyogo, 651-2273, Japan

    Toshitaka Okuno

  11. Miyauchi Clinic, 4-10-5 Mukonoso, Amagasaki, Hyogo, 661-0035, Japan

    Keisuke Miyauchi

  12. Chayamachi Breast Clinic, 3-1 Chayamachi, Kita-ku, Osaka, Osaka, 530-0013, Japan

    Kazuyuki Wakita

  13. Hyogo Prefectural Tsukaguchi Hospital, 6-8-17 Minamitsukaguchi-cho, Amagasaki, Hyogo, 661-0012, Japan

    Hirofumi Suwa

  14. Hashimoto Clinic, 1-7-2 Sumiyoshihommachi, Higashinada-ku, Kobe, Hyogo, 658-0051, Japan

    Takashi Hashimoto

  15. Department of Surgery, Takarazuka Municipal Hospital, 4-5-1 Kohama, Takarazuka, Hyogo, 665-0827, Japan

    Masayuki Nishino

  16. Department of Surgery, Kinki Central Hospital, 3-1 Kurumazuka, Itami, Hyogo, 664-8533, Japan

    Takashi Matsumoto

  17. Kobe Century Memorial Hospital, 1-9-1 Misaki-cho, Hyogo-ku, Kobe, Hyogo, 652-0855, Japan

    Toshiharu Hidaka

  18. Kobe Urban Breast Clinic, 4-1-6 Kumoidori, Chuo-ku, Kobe, Hyogo, 651-0096, Japan

    Yutaka Konishi

  19. Department of Breast Surgery, Hyogo Prefectural Kakogawa Medical Center, 203 Kanno, Kanno-cho, Kakogawa, Hyogo, 675-8555, Japan

    Yoko Sakoda

  20. Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamatedori, Chuo-ku, Kobe, Hyogo, 650-0011, Japan

    Akihiro Miya

  21. Department of Breast and Endocrine Surgery, Meiwa Hospital, 4-31 Agenaruo-cho, Nishinomiya, Hyogo, 663-8186, Japan

    Masahiro Kishimoto

  22. Nishikawa Clinic, 12-41 Nishidaimotsu-cho, Amagasaki, Hyogo, 660-0827, Japan

    Hidefumi Nishikawa

  23. Department of Breast and Endocrine Surgery, Kobe University School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan

    Seishi Kono

  24. Kokufu Breast Clinic, 1-10-6 Takarazuka, Hyogo, 665-0861, Japan

    Ikuo Kokufu

  25. Sakita Clinic, 2-35-101 Wajo-cho, Nishinomiya, Hyogo, 662-0971, Japan

    Isao Sakita

  26. Kitatsuji Clinic, 3-1-1 Nishitachibana-cho, Amagasaki, Hyogo, 660-0054, Japan

    Koushiro Kitatsuji

  27. Kobe Adventist Hospital, 8-4-1 Arinodai, Kita-ku, Kobe, Hyogo, 651-1321, Japan

    Koushi Oh

  28. Department of Medical Informatics, Niigata University Medical and Dental Hospital, Asahimachidori 1-754, Chuo-ku, Niigata, 951-8520, Japan

    Kouhei Akazawa

  29. Division of Breast and Endocrine Surgery, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Yasuo Miyoshi

Authors
  1. Kaori Tane
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  2. Chiyomi Egawa
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  3. Shintaro Takao
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  4. Kazuhiko Yamagami
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  5. Masaru Miyashita
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  6. Masashi Baba
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  7. Shigetoshi Ichii
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  8. Muneharu Konishi
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  9. Yuichiro Kikawa
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  10. Junya Minohata
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  11. Toshitaka Okuno
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  12. Keisuke Miyauchi
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  13. Kazuyuki Wakita
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  14. Hirofumi Suwa
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  15. Takashi Hashimoto
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  16. Masayuki Nishino
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  17. Takashi Matsumoto
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  18. Toshiharu Hidaka
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  19. Yutaka Konishi
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  20. Yoko Sakoda
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  21. Akihiro Miya
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  22. Masahiro Kishimoto
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  23. Hidefumi Nishikawa
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  24. Seishi Kono
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  25. Ikuo Kokufu
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  26. Isao Sakita
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  27. Koushiro Kitatsuji
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  28. Koushi Oh
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  29. Kouhei Akazawa
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  30. Yasuo Miyoshi
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Corresponding author

Correspondence to Yasuo Miyoshi.

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Funding source

This study was funded by the Hyogo College of Medicine.

Conflict of interest

Y. Miyoshi received honoraria and research fund from Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., GlaxoSmithKline K.K., Novartis Pharma K.K, and Taiho Pharmaceutical Co., Ltd.; M. Miyashita received honoraria from Daiichi-Sankyo Co., Ltd., Pfizer Inc., and Sawai Pharmaceutical Co., Ltd.; T. Okuno received honoraria from Chugai Pharmaceutical Co., Ltd, Eisai Co., Ltd., and Novartis Pharma K.K. The other authors have no conflict of interest.

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Tane, K., Egawa, C., Takao, S. et al. Body mass index and menopausal disorders during menopause affect vasomotor symptoms of postmenopausal Japanese breast cancer patients treated with anastrozole: a prospective multicenter cohort study of patient-reported outcomes. Breast Cancer 24, 528–534 (2017). https://doi.org/10.1007/s12282-016-0735-y

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  • DOI: https://doi.org/10.1007/s12282-016-0735-y

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