Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Older Women With Ductal Carcinoma in Situ

A look at treatment options

There were no statistically significant differences in physical or mental health outcomes in postmenopausal patients with ductal carcinoma in situ treated with either anastrozole or tamoxifen, and decisions about treatment should be determined by the risk for serious adverse effects and the symptoms associated with each drug. This according to a study of 3,104 postmenopausal women with hormone-positive ductal carcinoma in situ treated by lumpectomy with clear resection margins and whole breast irradiation and randomly assigned to receive either tamoxifen (20 mg/day) or anastrozole (1 mg/day) for 5 years, and stratified by age (<60 years vs ≥60 years). Researchers found:

• There was no significant difference between treatment groups for physical health scores, mental health scores, energy and fatigue, or symptoms of depression.

• Vasomotor symptoms, difficulty with bladder control, and gynecological symptoms were significantly more severe in the tamoxifen group than in the anastrozole group.

• Musculoskeletal pain and vaginal symptoms were significantly worse in the anastrozole group than in the tamoxifen group.

Citation: Ganz PA, Cecchini RS, Julian TB, et al. Patient-reported outcomes with anastrozole versus tamoxifen for postmenopausal patients with ductal carcinoma in situ treated with lumpectomy plus radiotherapy (NSABP B-35): a randomized, double-blind, phase 3 clinical trial. [Published online ahead of print December 10, 2015]. Lancet. doi.org/10.1016/S0140-6736(15)01169-1.