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01-05-2020 | Breast Cancer | Original Article

Depomedroxyprogesterone acetate therapy for hot flashes in survivors of breast cancer: no unfavorable impact on recurrence and survival

Authors: Natalie M. Ertz-Archambault, Lana B. Rogoff, Heidi E. Kosiorek, Brenda J. Ernst, Karen S. Anderson, Barbara A. Pockaj, Richard J. Gray, Donald W. Northfelt

Published in: Supportive Care in Cancer | Issue 5/2020

Abstract

Purpose

Survivors of estrogen receptor–expressing breast cancer generally do not receive estrogen-based therapy for menopausal symptoms due to concern for provoking recurrence of disease. Single-dose depomedroxyprogesterone acetate has been shown to be among the most effective non-estrogen strategies for treatment of menopausal hot flashes, but long-term evidence for safety in survivors is lacking.

Methods

We conducted an institutional review board approved, retrospective, case-control cohort study at a tertiary, academic referral center. Patients with estrogen receptor-expressing early-stage operable breast cancer who received depomedroxyprogesterone acetate for hot flashes between January 2005 and December 2012 were identified. We confirmed 75 patients who met strict inclusion criteria who were matched 1:1 with controls for age, stage of disease, HER2 status, and year of diagnosis. Overall survival, loco-regional recurrence-free survival, and progression-free survival assessments for cases were compared with controls.

Results

Median follow-up duration was 68.4 months in cases and 57.6 months in controls. Estimated local-regional recurrence-free survival at 10 years was 97% (95% CI, 92–100%) in cases and 98% (95% CI, 95–100%) in controls. Estimated progression-free survival at 10 years was 89% (95% CI, 80–100%) in cases and 83% (95% CI, 73–95) in controls. The majority (75%) of case patients experienced satisfactory relief of hot flashes from depomedroxyprogesterone injection.

Discussion

In this retrospective case-control study, we were unable to identify a detrimental effect of depomedroxyprogesterone acetate therapy for hot flashes in survivors of estrogen receptor–expressing breast cancer. Depomedroxyprogesterone acetate may be acceptable for management of hot flashes in this population.

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Title: Depomedroxyprogesterone acetate therapy for hot flashes in survivors of breast cancer: no unfavorable impact on recurrence and survival
Authors: Natalie M. Ertz-Archambault
Lana B. Rogoff
Heidi E. Kosiorek
Brenda J. Ernst
Karen S. Anderson
Barbara A. Pockaj
Richard J. Gray
Donald W. Northfelt
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Breast Cancer
Breast Cancer
Venlafaxine
Estrogens
Antiestrogens
Medroxyprogesterone Acetate
Published in: Supportive Care in Cancer / Issue 5/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-019-05013-7

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