Symptoms associated with oophorectomy and tamoxifen treatment for breast cancer in premenopausal Vietnamese women

There are very few data about the efficacy and toxicity of adjuvant systemi c therapies for breast cancer in nonwestern populations. In 1993 in Vietnam we began a randomized controlled clinical trial on premenopausal women wit h operable breast cancer comparing adjuvant surgical oophorectomy plus tamo xifen with observation and this same combined hormonal treatment on recurre nce. We evaluated the symptoms reported at regular follow-up visits by the first 482 premenopausal women entered in this clinical trial and treated wi th surgical oophorectomy plus tamoxifen or observation. Hot flash frequency and intensity, vaginal discharge, and genital pruritus were the only sympt oms to occur more frequently in oophorectomy and tamoxifen-treated subjects . Seventy-seven percent of oophorectomy/tamoxifen subjects reported grade 1 or more and 44% grade 2 or more hot flash frequency symptoms in the first 12 months, versus 9% and 1% of observation subjects, respectively. Twenty p ercent of oophorectomy/tamoxifen subjects had grade 2 or greater intensity of hot flashes some time in the first 12 months versus 0% in observation su bjects. Through three years, vasomotor symptoms were reported more frequent ly in oophorectomy/tamoxifen-treated women (in 23% vs. 3% at three years, m ostly grade I toxicities). While noted and persistent vasomotor symptoms we re found with oophorectomy plus tamoxifen in this population of Vietnamese women, these were of lower grades and tolerable. This adjuvant treatment ma y be widely accepted if it is demonstrated to be effective in this populati on.