Abstract P4-11-15: Breast cancer survivors vulvo-vaginal atrophy symptoms: Morphological aspects unveiled
Authors: de Mello Bianchi-Ferraro Ana Maria Homem , Lugollo Angela Flavia , Jarmy-di Bella Zsuzsanna IlonaKatalin , Sartori Marair GracioFerreira , Speck Neila Mariade Gois , Patriarca Marisa Teresinha , Dardes Rita de Cassiade Maio , Cantarelli Gabriela Cruz , Roberto Marcela Furtado , Dedonato Chayane , Nogueira Maria Cristina Caceres , Campos Madalena LeonorPereira , Oliveira Carla Dias , Facina Gil , Nazaro Afonso CelsoPinto , Girão Manoel JoãoBatistaCastelo 
Published: March 2022

Introduction: One of most frequent symptoms of breast cancer survivors using antiestrogen therapy (BCSA) is vulvovaginal atrophy (VVA). This condition decreases women's quality of life in many aspects such as social, sexual and psychological. Although this clinical condition is very frequent, few is kwon about morphological consequences that could affect function.Objective: Evaluate clinical signs and symptoms of VVA and to access histological and morphological features.Methods: Were selected BCSA with moderate or severe symptoms of VVA (score &gt;4 of visual analogic scale of symptoms - burning, discomfort, dryness, lack of vaginal lubrification, dyspareunia) and control group composed by non-oncological post menopause women with the same symptoms. They underwent to clinical evaluation of Vaginal Health Index (VHI), vaginal pH, validated quality of life questionnaires (Incontinence quality of Life- I-Qol, Female Sexual Function - index (FSF-I), and biopsy of vagina. Morphological variables evaluated were epithelial differentiation, presence of atrophy, stromal cellular and vascular distribution. Results: Were included 62 women, 50 BCSA (18 - tamoxifen and 32 - anastrozole) and 12 control group. The groups have similar age, time of menopause, BMI and parity, the mean time of anti-estrogen agent use was 2 to 5 years. Clinical evaluation and quality of life questionnaires scores are presented on table 1.

Vaginal biopsy findings revealed were presented on table 2

Conclusion: Symptoms of VVA do not correlate with tissue modifications as expected, however a trend of enhance of papillomatosis and subepithelial vascularization was observed, and they were predominant in BCSA compared to controls.

TamoxifenAnastrozolePost-menopause controlN183212VHI (Mean±SD)16.6 (±3.2)13.7 (±3.9)15.7 (±4.7)Vaginal pH (Mean±SD)5.3 (±0,7)6.2 (±0.4)4.9 (±1.5)IU n/%9 (50%)12 (37.5%)4 (33.4%)nocturia n/%3 (16.7%)2 (6.25%)3 (25%)I-Qol (Mean±SD)57.3 (±18.2)57.9 (±19.6)84.4 (±25.4)Active sexual life n/%14 (77.8%)18 (56.2%)7 (58.33%)FSF-I (Mean±SD)14.7 (±5,1)15.7(±6.2)21.1(±8.4)

TamoxifenAnastrozolePost-menopause control groupN183212Reduction in epithelial layers1 (5.5%)4 (12.5%)1 (8.3%)Reduction of epithelial maturation1(5,5%)5 (15.6%)1(8.3%)Enhance of epithelial papillae12 (66.7%)15 (46.8%)2 (16.7%)Enhance of subepithelial vascularization5 (27.8%)14 (43.7%)2 (16.7%)Reduction of Stromal cellular density1(5.5%)3 (9.4)0 (0%)

Citation Format: Ana Maria Homem de Mello Bianchi-Ferraro, Angela Flavia Lugollo, Zsuzsanna IlonaKatalin Jarmy-di Bella, Marair GracioFerreira Sartori, Neila Mariade Gois Speck, Marisa Teresinha Patriarca, Rita de Cassiade Maio Dardes, Gabriela Cruz Cantarelli, Marcela Furtado Roberto, Chayane Dedonato, Maria Cristina Caceres Nogueira, Madalena LeonorPereira Campos, Carla Dias Oliveira, Gil Facina, Afonso CelsoPinto Nazaro, Manoel JoãoBatistaCastelo Girão. Breast cancer survivors vulvo-vaginal atrophy symptoms: Morphological aspects unveiled [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-15.