Information provision for patients by breast cancer teams about the side-effects of hormone treatments

The choice of adjuvant hormone treatments in post-menopausal women with breast cancer increasingly includes anastrozole as an alternative to tamoxifen. Clearly there may be overlapping side-effects, but other important differences may have serious implications for health and quality of life. Patients consequently require information regarding the side-effects of recommended treatments and their comparisons. This study evaluates the extent of information provision about the side-effects of adjuvant anastrozole and tamoxifen by respective breast cancer professionals within 16 different breast care teams in the United Kingdom (UK). The study used interviews with individual members of breast cancer multidisciplinary teams (surgeons, oncologists and breast care nurses) from 11 cancer centres and 3 district general hospitals, to examine the information they give to patients relating to the side-effects of tamoxifen and anastrozole. The results show that vasomotor symptoms were the most frequently mentioned side-effect for both treatments. All teams, in large part addressed the adverse effects of both treatments (endometrial cancer and thrombo-embolic events for tamoxifen and anastrozole-associated loss of bone density). There was variation between the different professionals as to how frequently side-effects were mentioned. The greatest discrepancies occurred between the information given by team members and that included in patient information leaflets. In some cases, important information pertaining to side-effects was omitted from leaflets. This study suggests the need to standardise information-provision nationally in the UK and within breast cancer teams regarding the evidence-based side-effects of tamoxifen and anastrozole.