Evidence map›Paper›PMID 31958661›Full record

Trial reportBreast (Edinburgh, Scotland)2020

Complementary and alternative medicine and musculoskeletal pain in the first year of adjuvant aromatase inhibitor treatment in early breast cancer patients.

C C Hack, L Häberle, S Y Brucker, W Janni, B Volz, C R Loehberg, A D Hartkopf, C-B Walter, G Baake, A Fridman and 35 more

Open access · goldAbstract readClinical Trial, Phase IVMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Breast (Edinburgh, Scotland), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Musculoskeletal symptoms associated with aromatase inhibitors in the treatment of early breast cancer: A scoping review of risk factors and outcomes.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  5. Article
  6. Review
  7. Transiently Expressed Mistletoe Lectin II inMolecules (Basel, Switzerland) · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

45 authors at 18 institutions in 2 countries.

C C HackDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
L HäberleDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Biostatistics Unit, Department of Gynecology, Erlangen University Hospital, Erlangen, Germany.
S Y BruckerDepartment of Gynecology, University of Tübingen, Tübingen, Germany.
W JanniDepartment of Gynecology, Ulm University Hospital, Ulm, Germany.
B VolzDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
C R LoehbergDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; St. Theresien Hospital, Nuremberg, Germany.
A D HartkopfDepartment of Gynecology, University of Tübingen, Tübingen, Germany.
C-B WalterDepartment of Gynecology, University of Tübingen, Tübingen, Germany.
G BaakeOncological Medical Practice Pinneberg, Pinneberg, Germany.
A FridmanBreast Center, Department of Obstetrics and Gynecology, University of Cologne Hospital, Cologne, Germany; Evangelisches Krankenhaus Kalk, Cologne, Germany.
W MalterBreast Center, Department of Obstetrics and Gynecology, University of Cologne Hospital, Cologne, Germany.
R WuerstleinBreast Center, Department of Obstetrics and Gynecology, University of Cologne Hospital, Cologne, Germany; Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany.
N HarbeckBreast Center, Department of Obstetrics and Gynecology, University of Cologne Hospital, Cologne, Germany; Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany.
O HoffmannDepartment of Gynecology, Essen University Hospital, Essen, Germany.
S KuemmelBreast Unit, Essen Mitte Clinics, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany.
B MartinTuttlingen Clinic, Tuttlingen, Germany.
C ThomssenDepartment of Gynecology, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany.
H GrafHelios Clinics Meiningen, Meiningen, Germany.
C WolfUlm Medical Center, Ulm, Germany.
M P LuxDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
C M BayerDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
C RauhDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
K AlmstedtDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Department of Gynecology, Mainz University Hospital, Mainz, Germany.
P GassDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
F HeindlDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
T BrodkorbDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
L WillerDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
C LindnerAgaplesion Diakonie Clinic Hamburg, Hamburg, Germany.
H-C KolbergDepartment of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, Germany.
P KrabischDepartment of Gynecology, Klinikum Chemnitz gGmbH, Chemnitz, Germany.
M WeigelDepartment of Gynecology, Leopoldina Hospital Schweinfurt, Schweinfurt, Germany.
D Steinfeld-BirgGynecologic Onocologic Practice Steinfeld-Birg, Augsburg, Germany.
A KohlsProtestant County Hospital of Ludwigsfelde-Teltow, Ludwigsfelde-Teltow, Germany.
C BruckerDepartment of Gynecology and Obstetrics, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany.
V SchulzGynecologic Practice Abts+partner, Kiel, Germany.
G FischerMittweida Hospital gGmbH, Mittweida, Germany.
V PelzerDepartment of Gynecology, GFO Clinics Bonn, Bonn, Germany.
B RackDepartment of Gynecology, Ulm University Hospital, Ulm, Germany.
M W BeckmannDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
T FehmDepartment of Gynecology, University of Tübingen, Tübingen, Germany; Department of Gynecology, Heinrich Heine University of Dusseldorf, Dusseldorf, Germany.
A RodyDepartment of Gynecology, Campus Lübeck, Schleswig-Holstein University Hospital, Schleswig-Holstein, Germany.
N MaassDepartment of Gynecology, Campus Kiel, Schleswig-Holstein University Hospital, Schleswig-Holstein, Germany.
A HeinDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
P A FaschingDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany. Electronic address: peter.fasching@uk-erlangen.de.
N NabievaDepartment of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany.
Friedrich-Alexander-Universität Erlangen-Nürnberg · DEUniversity of Cologne · DEUniversity of Tübingen · DEUniversity Hospital Schleswig-Holstein · DEUniversity Hospital Ulm · DEAgaplesion Frankfurter Diakonie Kliniken · DEClinical Research Center Kiel · DEEssen University Hospital · DEHeinrich Heine University Düsseldorf · DEHochschule Mittweida · DEKliniken Essen-Mitte · DEKlinikum Chemnitz · DELeopoldina Krankenhaus Schweinfurt · DEMarienhospital Bottrop · DEMartin Luther University Halle-Wittenberg · DENuremberg Hospital · DERegio Kliniken · DEUniversity Hospital Augsburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with breast cancer (BC) show strong interest in complementary and alternative medicine (CAM), particularly for adverse effects of adjuvant endocrine treatment - e.g., with letrozole. Letrozole often induces myalgia/limb pain and arthralgia, with potential noncompliance and treatment termination. This analysis investigated whether CAM before aromatase inhibitor (AI) therapy is associated with pain development and the intensity of AI-induced musculoskeletal syndrome (AIMSS) during the first year of treatment. PATIENTS AND

methodsThe multicenter phase IV PreFace study evaluated letrozole therapy in postmenopausal, hormone receptor-positive patients with early BC. Patients were asked about CAM use before, 6 months after, and 12 months after treatment started. They recorded pain every month for 1 year in a diary including questions about pain and numeric pain rating scales. Data were analyzed for patients who provided pain information for all time points.

resultsOf 1396 patients included, 901 (64.5%) had used CAM before AI treatment. Throughout the observation period, patients with CAM before AI treatment had higher pain values, for both myalgia/limb pain and arthralgia, than non-users. Pain increased significantly in both groups over time, with the largest increase during the first 6 months. No significant difference of pain increase was noted regarding CAM use.

conclusionsCAM use does not prevent or improve the development of AIMSS. Pain intensity was generally greater in the CAM group. Therefore, because of the risk of non-compliance and treatment discontinuation due to the development of higher pain levels, special attention must be paid to patient education and aftercare in these patients.

Indexed as

Complementary TherapiesAgedAromatase InhibitorsArthralgiaBreast NeoplasmsFemaleGermanyHumansLetrozoleMiddle AgedMusculoskeletal PainMyalgiaPostmenopauseAromatase InhibitorsLetrozoleAromatase inhibitorsArthralgiaBreast cancerComplementary and alternative medicineEndocrine therapy/treatmentIntegrative medicineLetrozoleMyalgia

Identifiers

PMID31958661
PMCPMC7377331
OpenAlexW2999921189

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.