Most prevalent side effects of aromatase inhibitors in the treatment of hormone-positive breast cancer: a scoping review

Abstract

Hormone-positive breast cancer is the most commonly diagnosed breast neoplasm among postmenopausal women and is strongly associated with the effects of estrogens on hormone receptors of breast cells. Aromatase inhibitors are especially prescribed for treatment, and are effective to reduce mortality rates and the development of a new contralateral breast tumor. However, even with the proven efficacy and safety in use of these medications, approximately 50% of the patients abandon treatment before the prescribed period due to their side effects. The study was carried out with the objective of mapping what national and international literature declare about the most prevalent side effects caused by aromatase inhibitors in the treatment of women with hormonepositive breast cancer. We used the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review to elaborate this review. The methodology of choice was a scoping review aiming at synthetizing relevant information in an objective and clear manner about this drug class that is so common in breast cancer therapy, mainly benefitting women who are users of such drugs. According to the literature, reduced bone mineral density, arthralgia, hot flushes and dryness of the vaginal mucosa are the most reported symptoms, directly related with the absence of estrogen action on the body. These effects have a direct repercussion on the quality of life and on the discontinuation of treatment, leading to reduced functionality and high mortality rates.