Piotr Wysocki: Breast cancer patients may safely use vaginal estrogens

Piotr Wysocki, Head of Department of Oncology at Jagiellonian University Hospital, shared on LinkedIn:

“Breast cancer patients suffering from vaginal dryness during endocrine treatment may safely use vaginal estrogens.

Vaginal dryness is a typical adverse event in breast cancer patients undergoing endocrine treatment that may be detrimental to patients’ quality of life. Endovaginal estrogens represent an effective strategy to overcome this complication, but doubts remain regarding its safety, especially in patients with ER+ breast cancer.

The concerns are related to the potential increase of systemic estrogen levels following endovaginal administration, which could impede the anti-tumor activity of endocrine treatment.

A recent population-based study by McVicker L et al. in Jama Oncol (doi:10.1001/jamaoncol.2023.4508) evaluated the usage of endovaginal estrogens and HRT in 49,237 breast cancer patients. The study confirmed the lack of any detrimental effect of endovaginal estrogens on patients’ outcomes, irrespective of the dose of estrogens administered locally.

The risk of breast cancer–specific mortality in the pooled fully adjusted model confirmed similar outcomes of BC patients whether they used endovaginal estrogens or not (HR, 0.77; 95% CI, 0.63-0.94).

This study definitely supports the safety of endovaginal estrogens as a vaginal dryness preventive measure in BC patients undergoing endocrine treatment.”

Source: Piotr Wysocki/LinkedIn