Vaginal estrogen therapy for treatment of menopausal genitourinary syndrome among breast cancer survivors: a systematic review and meta-analysis

Abstract Objective: Assess survival outcomes and risk of recurrence in vaginal estrogen therapy (VET) users with medical history of breast cancer. Data source: The search strategy was guided by standardized terms and keywords were identified from controlled vocabularies. Following databases were u...

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Main Authors: Gabriel Moreira Lima Santos, Augusto Ostermann Magalhães, Pedro do Valle Teichmann, Maria Celeste Osório Wender
Format: Article
Language:English
Published: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 2025-08-01
Series:Revista Brasileira de Ginecologia e Obstetrícia
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032025000100309&lng=en&tlng=en
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author Gabriel Moreira Lima Santos
Augusto Ostermann Magalhães
Pedro do Valle Teichmann
Maria Celeste Osório Wender
author_facet Gabriel Moreira Lima Santos
Augusto Ostermann Magalhães
Pedro do Valle Teichmann
Maria Celeste Osório Wender
author_sort Gabriel Moreira Lima Santos
collection DOAJ
description Abstract Objective: Assess survival outcomes and risk of recurrence in vaginal estrogen therapy (VET) users with medical history of breast cancer. Data source: The search strategy was guided by standardized terms and keywords were identified from controlled vocabularies. Following databases were used for literature search: Pubmed, EMBASE, Cochrane, Scopus and Web of Science. Only studies published in the 21st century (2001–present) and written in English were included. Study selection: A total of 988 records were reviewed by two independent authors. After full-text analysis of 38 of them, 7 articles were included in the meta-analysis. Data collection: Data from eligible studies were extracted and tabulated based on predefined criteria: author, country, year, study type, sample size, type of intervention, use of aromatase inhibitors, duration of follow-up, and main outcomes. Results: 118.659 breast cancer survivors were analyzed, of whom 6.358 were treated with VET. The overall analysis showed no significant increase in the risk of recurrence (RR = 0.87, 95%CI: 0.67-1.11). VET users had a significant reduction in all-cause mortality (RR = 0.80, IC95%: 0.75–0,86). Conclusion: Vaginal estrogen therapy appears to be safe in the management of menopausal genitourinary syndrome in breast cancer survivors and it is related to significantly lower all-cause mortality. Prospective Register of Systematic Reviews (PROSPERO): CRD42024602047
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spelling doaj-art-6bb0a5cb01514bb890fdb78b484d462d2025-08-20T04:00:39ZengFederação Brasileira das Sociedades de Ginecologia e ObstetríciaRevista Brasileira de Ginecologia e Obstetrícia0100-72032025-08-014710.61622/rbgo/2025rbgo46Vaginal estrogen therapy for treatment of menopausal genitourinary syndrome among breast cancer survivors: a systematic review and meta-analysisGabriel Moreira Lima Santoshttps://orcid.org/0009-0002-7685-6879Augusto Ostermann Magalhãeshttps://orcid.org/0000-0001-7806-3034Pedro do Valle Teichmannhttps://orcid.org/0000-0003-0617-0927Maria Celeste Osório Wenderhttps://orcid.org/0000-0001-9085-4605Abstract Objective: Assess survival outcomes and risk of recurrence in vaginal estrogen therapy (VET) users with medical history of breast cancer. Data source: The search strategy was guided by standardized terms and keywords were identified from controlled vocabularies. Following databases were used for literature search: Pubmed, EMBASE, Cochrane, Scopus and Web of Science. Only studies published in the 21st century (2001–present) and written in English were included. Study selection: A total of 988 records were reviewed by two independent authors. After full-text analysis of 38 of them, 7 articles were included in the meta-analysis. Data collection: Data from eligible studies were extracted and tabulated based on predefined criteria: author, country, year, study type, sample size, type of intervention, use of aromatase inhibitors, duration of follow-up, and main outcomes. Results: 118.659 breast cancer survivors were analyzed, of whom 6.358 were treated with VET. The overall analysis showed no significant increase in the risk of recurrence (RR = 0.87, 95%CI: 0.67-1.11). VET users had a significant reduction in all-cause mortality (RR = 0.80, IC95%: 0.75–0,86). Conclusion: Vaginal estrogen therapy appears to be safe in the management of menopausal genitourinary syndrome in breast cancer survivors and it is related to significantly lower all-cause mortality. Prospective Register of Systematic Reviews (PROSPERO): CRD42024602047http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032025000100309&lng=en&tlng=enEstrogen replacement therapyEstrogensHormone replacement therapyMenopauseGenitourinary syndromeCancer survivorsBreast neoplasms
spellingShingle Gabriel Moreira Lima Santos
Augusto Ostermann Magalhães
Pedro do Valle Teichmann
Maria Celeste Osório Wender
Vaginal estrogen therapy for treatment of menopausal genitourinary syndrome among breast cancer survivors: a systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia
Estrogen replacement therapy
Estrogens
Hormone replacement therapy
Menopause
Genitourinary syndrome
Cancer survivors
Breast neoplasms
title Vaginal estrogen therapy for treatment of menopausal genitourinary syndrome among breast cancer survivors: a systematic review and meta-analysis
title_full Vaginal estrogen therapy for treatment of menopausal genitourinary syndrome among breast cancer survivors: a systematic review and meta-analysis
title_fullStr Vaginal estrogen therapy for treatment of menopausal genitourinary syndrome among breast cancer survivors: a systematic review and meta-analysis
title_full_unstemmed Vaginal estrogen therapy for treatment of menopausal genitourinary syndrome among breast cancer survivors: a systematic review and meta-analysis
title_short Vaginal estrogen therapy for treatment of menopausal genitourinary syndrome among breast cancer survivors: a systematic review and meta-analysis
title_sort vaginal estrogen therapy for treatment of menopausal genitourinary syndrome among breast cancer survivors a systematic review and meta analysis
topic Estrogen replacement therapy
Estrogens
Hormone replacement therapy
Menopause
Genitourinary syndrome
Cancer survivors
Breast neoplasms
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032025000100309&lng=en&tlng=en
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