Hot flashes and related outcomes in breast cancer survivors and matched comparison women

Abstract

Purpose/objectives: To compare the hot flash symptom experience and related outcomes between breast cancer survivors and healthy women.

Design: Descriptive, cross-sectional, comparative study.

Setting: Southeastern university medical center.

Sample: 69 of 207 breast cancer survivors contacted via a tumor registry and 63 age-matched healthy female volunteers. Survivors were a mean of 57 years and a mean of 39 months postdiagnosis.

Methods: Mailed survey included a demographic, disease, and treatment information form; a gynecologic history form; a two-day, prospective, hot flash diary; a detailed hot flash questionnaire; mood and affect scales; and the Hot Flash-Related Daily Interference Scale.

Main research variables: Hot flashes, mood, affect, interference with daily activities, and overall quality of life.

Findings: Breast cancer survivors had hot flashes that were significantly more frequent, severe, distressing, and of greater duration. Breast cancer survivors were less likely to be using hormone replacement and more likely to have tried nonhormonal prescription interventions in the past, but reported significantly less effectiveness from hot flash treatments. Breast cancer survivors with severe hot flashes reported significantly greater mood disturbance; higher negative affect; more interference with daily activities, including sleep, concentration, and sexuality; and poorer overall quality of life in comparison to breast cancer survivors with no hot flashes to mild hot flashes. Hot flash quality and triggers were not significantly different between groups. No clear temporal pattern of hot flashes emerged.

Conclusions: Hot flashes are a significant problem for breast cancer survivors, even for those who are naturally postmenopausal (i.e., did not undergo menopause as a result of surgery or the effects of chemotherapy). Hot flashes remained fairly stable over time and did not diminish in frequency, severity, or associated distress.

Implications for nursing: The findings guide the assessment of the uniqueness of the problem of hot flashes experienced by breast cancer survivors and help define outcomes to address in clinical practice or include in future hot flash intervention research.