Hormone therapy in the treatment of breast cancer in female patients: an integrative review





Breast Neoplasms; Hormones; Aromatase inhibitors; Tamoxifen; Fulvestrant.


Objective: Discuss the use of hormone therapy and the effects of its administration in the treatment of breast cancer in female patients. Method: Integrative review, carried out in July 2020, in the Scopus, Web of Science and Virtual Health Library databases, using the search strategy: “breast cancer” [AND] “aromatase inhibitors”; “breast cancer” [AND] “fulvestranto”; “breast cancer” [AND] “tamoxifen”.  Results: 23 articles were selected, grouped according to the therapy used. Fulvestranto (30.43% of the articles), was effective in postmenopausal and palliative care; aromatase inhibitors (56.52% of the articles), obtained efficacy in association with another medication and alone in primary and metastatic breast cancer; tamoxifen (47.82% of the articles), demonstrated positive results as an adjuvant. As for side effects, the three drugs had complications. It should also be noted that the profile of women varied in age (18 to 82 years) and physiological aspects (pre and post menopause) Final considerations: Hormone therapy plays an important role in the treatment of women with breast cancer. However, it is necessary to consider the individual characteristics of the patients, since adverse effects can be avoided when the hormone is well administered, significantly altering the patients' quality of life.


Acog Committee Opinion. (2006). No. 336: Tamoxifen and uterine cancer. Obstet Gynecol. 107 (6): 1475-8.

Asano, Y., Kashiwagi, S., Nagamori, M., Tanaka, S., Kuwae, Y., Amano, R., & Ohira, M. (2019). Pure mucinous breast carcinoma with micropapillary pattern (MUMPC): case report. Oncology Case Reports; 12 (2): 554-59.

Barros, M.A. et al. (2000) Efeitos colaterais em quimioterapia: complicações neurológicas. Bases da enfermagem em quimioterapia. Lemar, 340-350, 2000.

Beyea, S. C., Nicoll, L. H. (1998). Writing an integrative review. AORN J. 67 (4): 877-80.

Brasil. (2019a). Estadiamento. Instituto Nacional de Câncer.

Brasil. (2019b). Departamento de Regulação, Avaliação e Controle/Coordenação Geral de Sistemas de Informação. Secretaria de Atenção à Saúde.

Brasil. (2016). Tratamento pelo Sistema Único de Saúde. Instituto Nacional de Câncer.

Bozkaya, Y., Erdem, G. U., & Demirci, N. S. (2019). In the case of anastrozole-related hallucinations, can switching to letrozole be a treatment option? A case report and literature review. J Oncol Pharm Pract. 25 (3): 754-57.

Boér, K. (2017). Fulvestrant in advanced breast cancer: evidence to date and place in therapy. Therapeutic advances in medical oncology, 9 (7): 465-79.

Buzdar, A. U., Jones, S. E., Vogel, C. L., Wolter, P., & Webster, A. (1997). A phase III trial comparing anastrozole (1 and 10 milligrams), a potent and selective aromatase inhibitor, with megestrol acetate in postmenopausal women with advanced breast carcinoma. Arimidex Study Group. Cancer. 79 (4): 730-9.

Burstein, H. J., Prestrud, A. A., Seidenfeld, J., Anderson, H., Buchholz, T. A., Davidson, N. E., & Griggs, J. J. (2010). American society of clinical oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol 2010; 28 (23): 3784-96.

Cantinelli, F. S., Camacho, R. S., Smaletz, O., Gonsales, B. K., Braguittoni E, & Jr, J. R. (2006). A oncopsiquiatria no câncer de mama: considerações a respeito de questões do feminino. Rev. psiquiatr. clín. 2006 (São Paulo); 33 (3): 124-133.

Chhatrala, H. S., Khuu, J., & Zuberi, L. (2019). A rare case of triple positive metachronic breast cancer. J Investig Med High Impact Case Rep. 2324709619892106.

Chung, W., Hsu, Y., Chen, Y., & Hsu, H. (2019). Treatment of a patient with breast cancer and glucose 6-phosphate dehydrogenase deficiency: a case report. Medication, 98 (13): e14987.

Colozza, M., Califano, R., Minenza, E., Dinh, P., & Azambuja, E. (2008). Aromatase inhibitors: a new reality for the adjuvant endocrine treatment of early-stage breast cancer in postmenopausal women. Mini Rev Med Chem; 8 (6): 564-74.

Coral-Casas, J., Ricaurte-Fajardo, A., McCormick, S. J., Baracaldo, I., Jimenez, C. A., & Mejia, J. A. (2019). Sindrome de vasoconstriccion cerebral reversible asociado a anastrozol: una causa inusual de alto impacto. / [Reversible cerebral vasoconstriction syndrome associated with anastrozole: an unusual cause of high impact]. Rev Neurol; 68 (6): 250-54.

Christensen, S., Pedersen, L., Grijota, M., Kornum, J. B., Beiderbeck, A., & Sørensen, H.T. (2008). Incidence of interstitial pneumonitis among breast cancer patients: a 10-year Danish population-based cohort study. Br J Cancer. 98 (11): 1870–75.

Dziamski, K.M., Kalakonda, A., & Kohlitz, P. (2019). A rare case of jaundice associated with fulvestrants and hepatotoxicity. Am J Ther. 26 (1): e122-e123.

Deligdisch, L., Kalir, T., Cohen, C.J., Latour, M., Bouedec, G.L., & Penault-Llorca, F. (2000). Endometrial histopathology in 700 patients treated with tamoxifen for breast cancer. Gynecol Oncol. 78 (2): 181-6.

Demirci, N.S., Erdem, G.U., Uçgun, N.I., Bozkaya, Y., Ozdemir, N.Y., Dogan, M., & Zengin, N. (2019). A rare case: retinal branch vein occlusion associated with tamoxifen use. Journal of Cancer Research and Therapeutics, 15 (3): 722-24.

Ferreira, N.S.A. (2002). As pesquisas denominadas “estado da arte”. Educ Soc. 2002; 23 (79): 257-72.

Globocan. (2018). Globocan 2018: carga global do câncer. OncoNews Informação e Evidência. 2018.

Ghislain, P.D., Roujeau, J.C. (2002). Treatment of severe drug reactions: Stevens-Johnson syndrome, toxic epidermal necrolysis and hypersensitivity syndrome. Dermatol Online J. 2002 Jun; 8 (1): 5.

Goldhirsch, A., Wood, W.C., Gelber, R.D., Coates, A.S., Thürlimann, B., & Senn, H.J. (2007). Gallen conference. Progress and promise: highlights of the International Expert Consensus on the Primary Therapy of Early Breast Cancer 2007. Ann Oncol. 2007 Jul; 18 (7): 1133-44.

Goldhirsch, A., Wood, W.C., Gelber, R.D., Coates, A.S., Thürlimann, B., & Senn, H.J. (2011). Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early. Breast Cancer 2011. Ann Oncol. 2011 Ago; 22 (8): 1736–47.

Goldhirsch, A., Ingle, J.N., Gelber, R.D., Coates, A.S., Thürlimann, B., & Senn, H.J. (2009). Thresholds for therapies: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2009. Ann Oncol. 2009 Ago; 20 (8): 1319-29.

Haddad, C.F. (2010). Trastuzumab no câncer de mama. Revista Femina 2010; 38 (2): 74-78.

INCA. (2019). Rio Grande do Sul e Porto Alegre: estimativa dos casos novos. Rio de Janeiro: Instituto Nacional de Câncer, 2019.

INCA. (2020b). Câncer de mama. Rio de Janeiro: Instituto Nacional de Câncer, 2020b.

INCA. (2011). ABC do câncer: abordagens básicas para o controle do câncer. Rio de Janeiro: Instituto Nacional de Câncer, 2011.

INCA. (2020c). Estimativa 2020: incidência de câncer no Brasil. Rio de Janeiro: Instituto Nacional de Câncer, 2020c.

INCA. (2020a). Atlas de Mortalidade por Câncer. Rio de Janeiro: Instituto Nacional de Câncer, 2020a.

Jager, J.J., Keymeulen, K., Beets-Tan, R.G.H., Hupperets P., Kroonenburgh, M., Houben, R., Ruysscher, D., Lambin, P., & Boersma, L.J. (2010). FDG-PET-CT for staging of high-risk breast cancer patients reduces the number of further examinations: a pilot study. Acta Oncol.; 9 (2): 185-91, 2010.

Kimizuka, K., Inoue, K., Nagai, S.E., Saito, T., Nakano, S., Futsuhara, K., …, & Kurosumi, M. (2019). Observational multicentre study of Fulvestrant 500 mg in Japanese postmenopausal women with advanced or recurrent breast cancer positive for estrogen receptors after previous endocrine treatment. Nippon Medical School Journal 2019; 86 (3): 165-71.

Kwon, E., Kim, M., Choi, E., Park, Y., & Kim, C. (2019). Acute eosinophilic pneumonia induced by tamoxifen in a patient with breast cancer. International Journal of Surgery Case Reports 2019; 60: 186-90.

Lee, C.I., Goodwin, A., & Wilcken, N. (2017). Fulvestrant for hormone‐sensitive metastatic breast cancer. Cochrane Database Syst Rev. 2017 Jan; 2017 (1): CD011093.

Loretan, L., Moskovszky, L.E., Kurrer, M., Exner, G.U., & Trojan, A. (2019). Efficacy of a CDK4 / 6 inhibitor in a patient with breast cancer and liposarcoma: case report and literature review. Breast Care 2019; 14 (5): 325-28.

Maass, N., Ostermann, H., Possinger, K., Klein, P., Tesch, H., Mühlenhoff, L., & Dirk Bauerschlag, D. (2019). ACT-FASTER, a prospective cohort study exploring patterns of treatment with fulvestrant and exemestane in postmenopausal patients with breast cancer positive for advanced hormone receptors in real life conditions in Germany. Breast Care (Basel) 2019 Dez; 14 (6): 401-408.

Mendes, K.D.S., Silveira, R.C.C.P., & Galvão, C.M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem integrative literature. Texto & Contexto Enferm, (Florianópolis) 2008 Out/Dez; 17 (4): 758-64.

Morales-Conde, M., López-Ibáñez, N., & Calvete-Candenas, J. (2019). Fulvestrant-induced toxic epidermal necrolysis. A. Bras. Dermatol. 2019 (Rio de Janeiro); 94 (2): 218-20.

Murphy, C.C., Bartholomew, L.K., Carpentier, M.Y., Bluethmann, S.M., & Vernon, S.W. (2012). Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review. Breast Cancer Res Treat. 2012 Jul; 134 (2): 459-78.

Najim, O., Seghers, S., Sergoynne, L., Gaver, H.V., Papadimitriou, K., Wouters, K., Trinh, X.B., Huizing, M.T., & Tjalma, W. (2019). The association between type of endocrine therapy and development of estrogen receptor-1 mutation(s) in patients with hormone-sensitive advanced breast cancer: A systematic review and meta-analysis of randomized and non-randomized trials. Biochim Biophys Acta Rev Cancer 2019 Dez; 1872 (2): 188315.

Noureddin, B.N., Seoud, M., Bashshur, Z., Salem, Z., Shamseddin, A., & Khalil, A.. Ocular Toxicity in low – dose tamoxifen: a prospective study. Eye. 1999 Dez; 13 (6): 729-33.

Oliveira, A.T., & Queiroz, A.P. (2012). Perfil de uso da terapia antineoplásica oral: a importância da orientação farmacêutica. Rev Bras Farm Hosp Serv Saúde 2012 (São Paulo); 3 (4): 24-29.

Öztürk, Ç., Çay, T., Tetikkurt, S., Kasımogulları, E.V., & Karacan, T. (2019). Case report of atypical endometrial stromal cells in an endometrial polyp and giant osteoclastic cells in leiomyoma in the same patient: Is it a coincidence or is it the result of treatment with tamoxifen? Acta Biomed. 2019; 90 (4): 572–76.

Palumbo, R., Sottotetti, F., Quaquarini, E., Gambaro, A., Ferzi, A., Tagliaferri, B.. …, & Bernardo, A. (2019). Patterns of treatment and outcome with 500 mg of fulvestrant in postmenopausal women with positive metastatic breast cancer for hormone receptors / HER2 negative: a multicenter Italian experience in real life. Therapeutic advances in medical oncology 2019 jun; 11: 1758835919833864.

Pavilidis, N.A., Petris, C., Briassoulis, E., Klouvas, G., Psilas, C., Rempapis, J., & Petroutsos G. (1992). Clear evident that long-term, low-dose tamoxifen treatment can induce ocular toxicity: a prospective study of 63 patients. Cancer. 1992 Jun 15; 69 (12): 2961-4.

Pereira, A. S, Shitsuka, D. M., Parreira, F. J., & Shitsuka R. Metodologia da Pesquisa Científica. 1º. Ed. Santa Maria/RS: UAB/NTE/UFSM. 2018. Disponível em: Acesso em 03 Mar 21

Perrone F., Nuzzo, F., Rella, F.D., Gravina, A., Iodice, G., Labonia, V, ..., & Matteis, A. (2015). Weekly docetaxel versus CMF as adjuvant chemotherapy for older women with early breast cancer: final results of the randomized phase III ELDA trial. Ann Oncol. 2015 Abr; 26 (4): 675-82.

Pompeo, D.A., & Rossi, L.A. (2009). Revisão integrativa: etapa inicial do processo de validação de diagnóstico de enfermagem. Acta paul. enferm. 2009; 22 (4): 434-438.

Qadir, D., Chua, M., & Sulaiman S. (2019). Retained products of conception in hysteroscopy in a patient with breast cancer on tamoxifen. BMJ Case Rep. 2019 Ago 30; 12 (8): e230635.

Robertson, J.F., Bondarenko, I.M., Trishkina, E., Dvorkin, M., Panasci, L., Manikhas, A., …, & Ellis, m.J. (2016). Fulvestrant 500 mg versus anastrozole 1 mg for hormone receptor-positive advanced breast cancer (FALCON): an international,randomised, double-blind, phase 3 trial. The Lancet. 2016 Dez 17; 388 (10063): 2997-3005.

Silva, I.M.C., & Gonçalves, E.G.R. (2017). Câncer de mama e meio ambiente: uma revisão integrativa. São Luís, 2017.

Sedloev, T., Vlahova, A., Usheva, S., Vasileva-Slaveva, M., Spiridonova, T., & Spirdonov, J. (2019). Long-term survival and complete response to anastrozole in breast cancer patients with only skin metastases. Anticancer Res. 2019 Ago; 39 (8): 4393-98.

Segala, D., Gobbo, S., Pesci, A., Martignoni, G., Santoro, A., Angelico, G., ..., & Zannoni, G. F. (2019). Uterine tumor related to tamoxifen similar to ovarian sex cord tumor (UTROSCT): case report and literature review of this possible association. Pathol Res Pract. 2019 Mai; 215 (5): 1089-92.

Smeltzer S.C., Bare, B.G., Brunner, & Suddarth. (2006). Tratado de enfermagem médico-cirúrgica. Guanabara Koogan 2006 (Rio de Janeiro); 10 (3).

Sorscher S. (2019). Quantitative assays of mRNA expression and synchronous breast cancer: case report. Case Rep Oncol 2019; 12 (2): 418–20.

Tanaka, A., Yamashita, C., Hinogami, H., Shirai, H., Yamamura, J., & Itoc, R. (2019). Localized adverse skin event induced by anastrozole as an adjunctive treatment for breast cancer: case report. Dermatology Case Reports 2019 jan/abr; 11 (1): 57–63.

Tenti, S., Giordano, N., Cutolo, M., Giannini, F., & Fioravanti, A. (2019). Primary antiphospholipid syndrome during treatment with aromatase inhibitors: case report and literature review. Medication 2019 Mar; 98 (13): e15052.

Timmers, L., Boons, C.C.L.M., Kropff, F., Vem, P.M.V., Swart, E.L., Smit, E.F., ..., & Hugtenburg, J.G. (2014). Adherence and patients’ experiences with the use of oral anticancer agents. Acta Oncol. 2014 Fev; 53 (2): 259-67.

Visvanathan, K., Chlebowski, R.T., Hurley, P., Col, N.F., Ropka, M., Collyar, D., …, & Lippman, S.M. (2009). American Society of Clinical Oncology Clinical Practice Guideline Update on the Use of Pharmacologic Interventions Including Tamoxifen, Raloxifene, and Aromatase Inhibition for Breast Cancer Risk Reduction. J Clin Oncol. 2009 Jul 1; 27 (19): 3235-58.

Xie, Y., Li, Y., Zhang, Y., Zhang, S., Li, W., Guan, X., …, & Wang, B. (2019). Fulvestrant 500 mg versus Exemestane in postmenopausal women with metastatic breast cancer resistant to non-steroidal aromatase adjuvant inhibitors in clinical practice: a multicenter retrospective study. Clinical breast cancer 2019 jun; 19 (3): 452-58.

Woodford, R.G., Becker, G.J., & Jain, A. (2019). Leukocytoclastic vasculitis associated with use of aromatase inhibitors. Intern Med J. 2019 set; 49 (9): 1162-67.

Whitmer, R.A., Quesenberry, C.P., Zhou, J., & Yaffe, K. (2011). Timing of hormone therapy and dementia: the critical window theory revisited. Ann Neurol. 2011 Jan; 69 (1):163-9.



How to Cite

PAULA , J. C. P. de .; ROCHA, V. M. P. .; BAYER, V. M. L. .; FICANHA, E. E.; SILVA, E. V. da . Hormone therapy in the treatment of breast cancer in female patients: an integrative review . Research, Society and Development, [S. l.], v. 10, n. 3, p. e26810313235, 2021. DOI: 10.33448/rsd-v10i3.13235. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/13235. Acesso em: 17 apr. 2021.



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