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!
New nanomedicine slips through the cracks
24.04.2019 | University of Tokyo
Sugar entering the brain during septic shock causes memory loss
23.04.2019 | Rensselaer Polytechnic Institute
Flexible, organic and printed electronics conquer everyday life. The forecasts for growth promise increasing markets and opportunities for the industry. In Europe, top institutions and companies are engaged in research and further development of these technologies for tomorrow's markets and applications. However, access by SMEs is difficult. The European project SmartEEs - Smart Emerging Electronics Servicing works on the establishment of a European innovation network, which supports both the access to competences as well as the support of the enterprises with the assumption of innovations and the progress up to the commercialization.
It surrounds us and almost unconsciously accompanies us through everyday life - printed electronics. It starts with smart labels or RFID tags in clothing, we...
The human eye is particularly sensitive to green, but less sensitive to blue and red. Chemists led by Hubert Huppertz at the University of Innsbruck have now developed a new red phosphor whose light is well perceived by the eye. This increases the light yield of white LEDs by around one sixth, which can significantly improve the energy efficiency of lighting systems.
Light emitting diodes or LEDs are only able to produce light of a certain colour. However, white light can be created using different colour mixing processes.
Researchers led by Francesca Ferlaino from the University of Innsbruck and the Austrian Academy of Sciences report in Physical Review X on the observation of supersolid behavior in dipolar quantum gases of erbium and dysprosium. In the dysprosium gas these properties are unprecedentedly long-lived. This sets the stage for future investigations into the nature of this exotic phase of matter.
Supersolidity is a paradoxical state where the matter is both crystallized and superfluid. Predicted 50 years ago, such a counter-intuitive phase, featuring...
A stellar flare 10 times more powerful than anything seen on our sun has burst from an ultracool star almost the same size as Jupiter
A localization phenomenon boosts the accuracy of solving quantum many-body problems with quantum computers which are otherwise challenging for conventional computers. This brings such digital quantum simulation within reach on quantum devices available today.
Quantum computers promise to solve certain computational problems exponentially faster than any classical machine. “A particularly promising application is the...
17.04.2019 | Event News
15.04.2019 | Event News
09.04.2019 | Event News
25.04.2019 | Materials Sciences
25.04.2019 | Earth Sciences
25.04.2019 | Life Sciences