Hormonal therapies for early breast cancer: systematic review and economic evaluation

Abstract

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Implications of Mobility Impairment on the Diagnosis and Treatment of Breast Cancer

“…Beyond arm functioning, mobility difficulties might affect treatment decision making on multiple levels, including anesthesia regimens, 27,28 chemotherapy dosages, mobility aid needs, thromboembolism risks, 29,30 osteoporosis, 30,31 and weight gains with adjuvant therapy (both chemotherapy and endocrine therapy). [32][33][34][35] At each point, multidisciplinary teams of clinicians should explicitly discuss with patients how their mobility might interact with or affect treatments and potential outcomes.…”

The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review.

“…Other RCTs also report a switch to an aromatase inhibitor after 2-3 years of TAM to be more efficacious than TAM alone for 5 years [ABCSG-6a, 23 27 has reported improved outcomes in patients who were given letrozole after 5 years of TAM. All of these findings have also been summarised in three systematic reviews, [28][29][30] and in an additional earlier review 31 that included three of the switching strategy trials.…”

“…The long-term use of TAM may be associated with vaginal bleeding, endometrial thickening and increased risk of endometrial cancer and thromboembolic events. 30 Aromatase inhibitors have been reported to result in fewer hot flushes but are also associated with increased joint pain and bone fractures, and may also be associated with increased cardiovascular risk. 30 This cardiovascular risk has also been reported in a subsequent meta-analysis, 32 although it was noted that the absolute difference was relatively low, and between 160 and 180 patients had to be treated to produce one event.…”

An international randomised controlled trial to compare TARGeted Intraoperative radioTherapy (TARGIT) with conventional postoperative radiotherapy after breast-conserving surgery for women with early-stage breast cancer (the TARGIT-A trial)

“…Unit costs were taken from a published source 81 and applied to patient-level data from the trial. Treatments for local recurrence were recorded in the trial and were costed on an individual patient basis.…”