Evolution of breast cancer treatments: current options and quality-of-life considerations

Data from patient self-report questionnaires provide valuable information about side effects that patients may view as having a significantly detrimental impact on their quality of life and yet are not always recognised as important by healthcare professionals. Such information is very important in enabling patients to make informed choices regarding treatment options. Despite this, formal data collection from patient self-report assessments still fails to influence management decisions as much as traditional outcome measures such as disease-free survival, or clinician-recorded symptoms. There are now a number of different options for the treatment of patients with breast cancer. These include antioestrogens, aromatase inhibitors and oestrogen receptor antagonists for postmenopausal women, and chemotherapy and ovarian ablation (via oophorectomy, irradiation or with luteinising hormone-releasing hormone agonists) for premenopausal women. However, there are still surprisingly few published reports from comprehensive quality-of-life studies comparing such treatments and thus little is known about the relative impacts of each of these on quality of life. Here, the evolution of hormonal therapies for breast cancer is reviewed and the differences between the tolerability profiles of currently available treatment options are highlighted.