Adjuvant Endocrine Therapy Increases Risks of Oral Health Problems in Breast Cancer Survivors

Risk of oral health issues are higher for women breast cancer survivors who received adjuvant endocrine therapy (ET), according to results of a study published in the American Journal of Nursing.

Adjuvant ET has been associated with adverse musculoskeletal effects, including tooth loss. As such, investigators from Ewha Woman’s University in South Korea and New York University hypothesized that adjuvant ET recipients would report more oral health complaints compared with nonrecipients after surviving breast cancer.

To test their hypothesis, data were sourced from the National Health and Nutrition Examination Survey (NHANES). Oral examination data collected from 423 women with breast cancer, aged 20 years and older, between 2009 and 2020 were evaluated on the basis of adjuvant ET receipt.

The study population was mostly 65 years of age or older (58.3%), White (80.5%), and never smokers (56.9%).

Overall, 22.1% received adjuvant ET, specifically anastrozole (7.8%), tamoxifen (7.1%), letrozole (4.3%), and exemestane (2.9%). Stratified by age, more women younger than 65 years took adjuvant ET than the older women (P =.038).

Adjuvant ET recipients had a higher rate of decayed teeth (27.5% vs 13.4%; P =.039) and gum disease or problems (27.2% vs 13.2%; P =.025), and tended to have poor oral hygiene (19% vs 10.8%; P =.094) compared with women who did not receive adjuvant ET. In addition, more ET recipients were recommended for immediate dental care (43.4%) than nonrecipients (26.1%; P =.020).

The opposite pattern was observed for coronal cavities, in which ET recipients had fewer cavities (mean, 1.97) than nonrecipients (mean, 4.44; P =.002).

The limitations of this study included the small sample size and the lack of data on previous cancer therapies.

“Evidence-based nursing interventions to address the oral effects of adjuvant endocrine therapy must be developed and tested,” concluded the study authors.

Reference

Park SH, Strauss SM. Oral health concerns of female breast cancer survivors on adjuvant endocrine therapy. Am J Nurs. 2023;123(10):24-29. doi:10.1097/01.NAJ.0000978924.32557.53