Management of Comorbidities in Early Breast Cancer

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As the number of breast cancer survivors continues to increases, the evaluation and management of comorbidities becomes more important. This panel discussion addresses the optimal management of the leading side effects associated with treatment of early stage breast cancer.

Christy A. Russell, MD, notes that when administering aromatase inhibitors (AIs) the most bothersome side effects are arthralgia and myalgia. She adds that some of the side effects associated with treatment are not discussed as often as they should be, such as urogenital atrophy and vaginal dryness. There are various approaches being studied using vitamin D or vaginal estrogen preparations, but conclusive data is not available on the efficacy of these approaches.

Debu Tripathy, MD, notes that some evidence suggests that body mass index (BMI) may have an impact on the efficacy of hormonal therapy. William J. Gradishar, MD, adds that obesity may also result in underdosing chemotherapy because of toxicity concerns. Moreover, trials examining adjuvant therapy suggests that a higher BMI may lessen the impact of therapy.

Russell notes that it seems to be unclear if losing weight after a diagnosis will improve outcomes. Russell adds that when deciding on a therapy, it is important to note that tamoxifen does not result in an added risk of gaining weight, according to the P1 prevention trial.