Non-hormonal interventions effective for hot flushes in women with a history of breast cancer

January 01, 0001

Non-hormonal interventions effective for hot flushes in women with a history of breast cancer

Clinical Question:How effective are non-hormonal interventions for hot flushes in women with a history of breast cancer?

Bottom line: Clonidine, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), and gabapentin reduced the number and severity of hot flushes. Vitamin E was not beneficial. One of two studies on relaxation therapy showed a significant benefit. None of the other non-pharmacological therapies (homeopathy, acupuncture and magnetic therapy) had a significant benefit.

Caveat:Methods of reporting continuous outcomes were inconsistent across studies, which precluded the possibility of pooling results. It was not possible to say if some treatments were better than others, and side effects were inconsistently reported. The main limitation in the quality of the evidence from this review relates to losses to follow-up, which ranged from 3% to 40% in the included studies. The loss of this data could potentially result in an overestimation of the true effect, by not considering participants who possibly had less benefit or no benefit at all. All studies produced information for short periods of follow-up (maximum 12 weeks).

Context:Hot flushes are common in women with a history of breast cancer. Hormonal therapies are known to reduce these symptoms but are not recommended in women with a history of breast cancer due to their potential adverse effects.

Cochrane Systematic Review:Rada G et al. Non-hormonal interventions for hot flushes in women with a history of breast cancer. Cochrane Reviews, 2010, Issue 9. Article No. CD004923. DOI: 10.1002/14651858. CD004923. Pub2. This review contains 16 studies involving 1985 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 295, January 2011.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: X. Female Genital System, Breast. Keywords: hot flushes, breast cancer, clonidine, selective serotonin reuptake inhibitors, SSRIs, serotonin-norepinephrine reuptake inhibitors, SNRIs, gabapentin
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 12 April 2011

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.