TY - JOUR
TI - Microablative Fractional CO2 Laser for Vulvovaginal Atrophy in Women With a History of Breast Cancer: A Pilot Study at 4-week Follow-up
AU - Salvatore, S.
AU - Nappi, R.E.
AU - Casiraghi, A.
AU - Ruffolo, A.F.
AU - Degliuomini, R.
AU - Parma, M.
AU - Leone Roberti Maggiore, U.
AU - Athanasiou, S.
AU - Candiani, M.
JO - Clinical Breast Cancer
PY - 2021
VL - 21
TODO - 5
SP - e539-e546
PB - W B SAUNDERS CO-ELSEVIER INC
SN - 1526-8209, 1938-0666
TODO - 10.1016/j.clbc.2021.01.006
TODO - adult;  Article;  breast cancer;  clinical article;  clinical assessment tool;  clinical effectiveness;  clinical outcome;  cohort analysis;  controlled study;  dyspareunia;  dysuria;  feasibility study;  female;  Female Sexual Function Index;  follow up;  hormonal therapy;  human;  Likert scale;  low level laser therapy;  medical history;  mental health;  microablative fractional carbon dioxide laser therapy;  middle aged;  patient safety;  patient satisfaction;  pilot study;  prospective study;  quality of life;  questionnaire;  sexual function;  sexual intercourse;  Short Form 12;  vagina atrophy;  vaginal burning sensation;  vaginal dryness;  Vaginal Health Index;  vaginal pruritus;  visual analog scale;  wellbeing;  breast tumor;  complication;  drug therapy;  gas laser;  pathology;  radiation response;  treatment outcome;  vagina disease;  vulva, Breast Neoplasms;  Female;  Follow-Up Studies;  Humans;  Lasers, Gas;  Middle Aged;  Patient Satisfaction;  Pilot Projects;  Quality of Life;  Treatment Outcome;  Vaginal Diseases;  Vulva
TODO - Background: Breast cancer (BC) is the most common female cancer worldwide. Menopausal symptoms are a well-known side effect in women with BC and have a significant negative impact on quality of life (QoL) and sexuality. Nowadays, hormonal replacement therapy and local estrogens are the most common prescriptions to treat vulvovaginal (VVA) symptoms. However, in women with a history of BC, proper therapy for such conditions remains an often inadequately addressed clinical problem. A treatment with microablative fractional CO2 laser (MLT) can produce a remodeling of the vaginal connective tissue without causing damage to the surrounding tissue. The aim of this pilot study is to assess the efficacy and safety of MLT for treating VVA symptoms in women with a history of BC at 20-week follow-up since the first laser treatment. Patients and Methods: Women with BC and VVA symptoms were enrolled in the study and treated with 5 laser applications (one every 4 weeks). The rate of satisfied patients at 20 weeks of follow-up was evaluated with a 5-point Likert scale. Changes of the Vaginal Health Index (VHI) after treatment was compared with baseline. Effects of the laser treatment on VVA symptoms was measured using a 10-cm visual analog scale (VAS). Changes in overall QoL were assessed with a generic QoL questionnaire: the Short Form 12 (SF-12) that we analyzed considering its physical (PCS12) and mental (MCS12) domains. Sexual function was evaluated by the Female Sexual Function Index (FSFI). Results: In this prospective cohort study, we enrolled 40 women with a history of BC and who currently were or (Group 2) who had been (Group 1) on treatment with endocrine therapy for their condition. Six (15.0%) women were very satisfied, 25 (62.5%) were satisfied, 6 (15.0%) were uncertain, and 3 (7.5%) were dissatisfied with the MLT. VVA symptoms and VHI improved significantly at 20 weeks from baseline (P < .05) with no differences between the 2 groups (P > .05). In terms of QoL measured by the SF-12, the PCS12 and the MCS12 significantly improved at the 20-week follow-up. A significant improvement in total FSFI and in all domains was reported in both study groups (P < .05) with no differences between groups (P > .05). Conclusion: MLT was safe and effective in treating VVA symptoms in women with a history of BC, irrespective of being previously or currently on endocrine therapies. © 2021 Elsevier Inc.
ER -