Vulvovaginal atrophy (VVA) is commonly reported among breast cancer patients and its aetiology is multifactorial. Traditionally use of systemic and topical oestrogens has been discouraged in hormone positive breast cancer due to concerns about its potential impact on cancer growth. Laser therapy has been reported to be beneficial for symptoms in women with VVA from menopause. We aimed to assess the symptomatic benefit of this treatment in women with early breast cancer (EBC).
A single arm investigator initiated pilot study was performed. Female EBC patients with symptomatic vulvovaginal atrophy were recruited between February 2016 and May 2017. Baseline data was collected on demographics and risk factors for VVA. Patients received 3 vaginal fractional CO2 laser treatments approximately 4 weeks apart. Questionnaires were completed at baseline, prior to each subsequent treatment and 4 weeks after completion of treatment. Our primary endpoint was symptomatic improvement of VVA on 10cm visual analog scale (VAS). Statistical analysis was performed with a Wilcoxon Signed Rank test with derived effect sizes.
24 patients with a median age of 56 were enrolled in our study. 23 patients had taken anti-oestrogen therapy. 20 patients’ data were available at the time of reporting. All symptoms on the 10cm VAS showed a significant response to treatment; the mean absolute change for dryness was 5.2 (p=<0.001), itch 3.2 (p=0.001), burning 3.0 (p=0.008), dysuria 2.3 (p=0.001) and dysparenunia 3.6 (p=0.002). Effect size ranged from moderate (0.4) to large (0.6).
EBC patients had symptomatic improvement in all 5 domains of VVA. This is both statistically significant and clinically relevant. The full results will be presented at the meeting.