The study is published online Nov. 11 in the journal Breast Cancer Research and Treatment. Preliminary findings were presented in 2010 at the 74th Annual Scientific Meeting of the American College of Rheumatology.
For many post-menopausal women with breast cancer promoted by the hormone estrogen, aromatase inhibitors (AI) can dramatically reduce the risk of their cancer coming back. Doctors say the AIs must be taken for five years to gain the full benefit, however, the development of joint complaints in up to 35 percent of women forces many of them to stop early out of concern that the pain signals a more serious condition.
"It's not clear why joint symptoms occur with AI use, but we wondered if it could be related to inflammation or an autoimmune disease," says rheumatologist Victoria K Shanmugam, MBBS, MRCP, assistant professor of medicine at Georgetown University Medical Center, and the study's lead author. "Our research ruled out both."
Forty-eight postmenopausal women with state I, II or III breast cancer treated at Georgetown Lombardi Comprehensive Cancer Center were invited to take part in the study. All had hand pain and no known autoimmune disease. Of them, 25 women were taking AIs; 23 women were not taking AIs.
Subjects were evaluated after abstaining from non-steroidal anti-inflammatory drugs for 48 hours. Signs of inflammation from arthritis would reappear in that time frame, the researchers reasoned. All the women completed a health assessment questionnaire. The rheumatologist conducted a personal history and physical examination with each patient. Various blood tests were conducted and x-rays and ultrasounds of all participants' hands were performed. The rheumatologist and radiologist did not know which participants were taking AIs and which were not.
"We found that several patients in the control arm had a similar constellation of symptoms to those receiving AIs, but our team did not find any conclusive evidence that women taking AIs were more likely to have inflammatory arthritis or an autoimmune disease," Shanmugam says.
An autoimmune disease was discovered in four of the 48 women – two in each group -- that had previously been undiagnosed. The cases were equally distributed among cases and controls.
"It would be prudent to refer those experiencing joint pain to a rheumatologist to rule out a previously undiagnosed autoimmune disease, and so that we can help address the symptoms," Shanmugam says.
"Although our study helps to rule out inflammatory arthritis or autoimmune disease as cause for joint pain associated with AIs, we still do not know why these women have musculoskeletal symptoms. Since the syndrome doesn't appear to be related to inflammatory arthritis or autoimmune disease, women should be encouraged to stay on their medication so they can gain the full benefit from it."
The authors report no related financial interests. This work was supported by a development grant from the Georgetown University Hospital Department of Internal Medicine, and by the Swing Fore the Cure Foundation. Shanmugam was supported by the Physician Scientist Development Award from the American College of Rheumatology Research and Education Foundation and is currently supported awards from the National Center for Research Resources at National Institutes of Health. In addition, Shanmugam is supported by a KL2 Mentored Career Development Program Scholar grant from Georgetown-Howard Universities Center for Clinical & Translational Science.
About Georgetown University Medical Center
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC's mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization (BGRO), which accounts for the majority of externally funded research at GUMC including a Clinical Translation and Science Award from the National Institutes of Health. In fiscal year 2010-11, GUMC accounted for 85 percent of the university's sponsored research funding.
Karen Mallet | EurekAlert!
Investigators may unlock mystery of how staph cells dodge the body's immune system
22.09.2017 | Cedars-Sinai Medical Center
Monitoring the heart's mitochondria to predict cardiac arrest?
21.09.2017 | Boston Children's Hospital
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
22.09.2017 | Life Sciences
22.09.2017 | Medical Engineering
22.09.2017 | Physics and Astronomy