Preexisting musculoskeletal burden and its development under letrozole treatment in early breast cancer patients

Journal article

Publication Details

Author(s): Nabieva N, Häberle L, Brucker SY, Janni W, Volz B, Löhberg C, Hartkopf AD, Walter CB, Baake G, Fridman A, Malter W, Wuerstlein R, Harbeck N, Hoffmann O, Kuemmel S, Martin B, Thomssen C, Graf H, Wolf C, Lux MP, Bayer CM, Rauh C, Hack C, Almstedt K, Gaß P, Heindl F, Brodkorb T, Lindner C, Kolberg HC, Krabisch P, Weigel M, Steinfeld-Birg D, Kohls A, Brucker C, Schulz V, Fischer G, Pelzer V, Rack B, Beckmann M, Fehm T, Rody A, Maass N, Hein A, Fasching P
Journal: International Journal of Cancer
Publication year: 2019
ISSN: 0020-7136


One of the most common adverse events (AEs) occurring during treatment with aromatase inhibitors (AIs) is musculoskeletal pain. The aim of our study was to analyze the influence of preexisting muscle/limb pain and joint pain on the development of AI-induced musculoskeletal AEs. Women eligible for upfront adjuvant endocrine therapy with letrozole were included in the PreFace study, a multicenter phase IV trial. During the first treatment year, they were asked to record musculoskeletal AEs monthly by answering questions regarding pain symptoms and rating the pain intensity on a numeric rating scale from 0 (no pain) to 10 (very strong pain). Pain values were compared using nonparametric statistical tests. Overall, 1,416 patients were evaluable. The average pain value over all time points in women with preexisting muscle/limb pain was 4.3 (median 4.3); in those without preexisting pain, it was 2.0 (median 1.7). In patients without preexisting muscle/limb pain, pain levels increased relatively strongly within the first 6 months (mean increase +0.9, p < 0.00001) in comparison with those with preexisting pain (mean increase +0.3, p < 0.001), resulting in a statistically significant difference (p < 0.00001) between the two groups. The development of joint pain was similar in the two groups. Women without preexisting muscle/limb pain or joint pain have the greatest increase in pain after the start of adjuvant AI therapy. Women with preexisting pain have significantly higher pain values. The main increase in pain values takes place during the first 6 months of treatment.

FAU Authors / FAU Editors

Beckmann, Matthias Prof. Dr.
Lehrstuhl für Geburtshilfe und Frauenheilkunde
Fasching, Peter PD Dr.
Professur für Translationale Frauenheilkunde und Geburtshilfe
Gaß, Paul Dr. med.
Hack, Carolin PD Dr.
Medizinische Fakultät
Hein, Alexander PD Dr.
Heindl, Felix
Medizinische Fakultät
Nabieva, Naiba Dr. med.

External institutions with authors

Eberhard Karls Universität Tübingen
Evangelisches Krankenhaus Kalk
Evangelisches Krankenhaus Ludwigsfelde-Teltow
GFO Kliniken Bonn
HELIOS Kliniken
Helmholtz-Zentrum für Umweltforschung GmbH (UFZ)
Inselspital, Universitätsspital Bern
Kliniken Essen-Mitte Evang. Huyssens-Stiftung/Knappschaft gGmbH
Klinikum Chemnitz
Klinikum Landkreis Tuttlingen
Krankenhaus Jerusalem
Landkreis Mittweida Krankenhaus
Leopoldina Krankenhaus Schweinfurt
Marienhospital Bottrop
Paracelsus Medizinische Privatuniversität, Nürnberg
Universitätsklinikum Essen
Universitätsklinikum Schleswig-Holstein (UKSH)
Universitätsklinikum Ulm

How to cite

Nabieva, N., Häberle, L., Brucker, S.Y., Janni, W., Volz, B., Löhberg, C.,... Fasching, P. (2019). Preexisting musculoskeletal burden and its development under letrozole treatment in early breast cancer patients. International Journal of Cancer.

Nabieva, Naiba, et al. "Preexisting musculoskeletal burden and its development under letrozole treatment in early breast cancer patients." International Journal of Cancer (2019).


Last updated on 2019-23-05 at 09:38