Liljegren, A., Gunnarsson, P., Landgren, B. M., Robeus, N., Johansson, H., & Rotstein, S. (2012). Reducing vasomotor symptoms with acupuncture in breast cancer patients treated with adjuvant tamoxifen: a randomized controlled trial. Breast Cancer Research and Treatment, 135, 791-798.doi:10.1007/s10549-010-1283-3
The study evaluated the value of true acupuncture in management of hot flashes in women with breast cancer receiving tamoxifen.
Patients on tamoxifen who experienced vasomotor symptoms were randomly assigned to true acupuncture or control acupuncture groups. All patients were treated for 20 minutes twice weekly for 5 weeks in an outpatient clinic. In the true acupuncture group, 8 needles were inserted at defined points. In the control group, needles did not penetrate the skin, but were rotated until the patient felt a superficial sensation on the skin. In the control group, the needles were placed at 8 sites, as well. Study data were collected at baseline, week 6, and week 18.
The study enrolled 74 women with a mean age of 58 years.
The study was conducted in an outpatient clinic in Sweden.
PHASE OF CARE: Transition phase after active treatment
The study was a single-blind, randomized, sham-controlled trial.
There were no significant differences between groups in frequency of hot flushes and sweating over time. The acupuncture group reported less severity of symptoms of sweating at night ( p = .03). Both groups demonstrated significant improvement in symptoms over time. Of those who received true acupuncture, 69.4% thought they had receiving true acupuncture, while 63.9% of those in the control group thought they had received true acupuncture, suggesting that patient blinding was accomplished. One adverse event of bleeding and bruising was reported in 1 control patient.
Findings suggest little difference in symptoms between those who received acupuncture versus those who received sham acupuncture. Acupuncture may have some benefit, but it is unclear if this also reflects a placebo effect from the intervention.
Study limitations included:
This study provides limited evidence regarding the effect of acupuncture for vasomotor symptoms in women with breast cancer treated with tamoxifen. It does demonstrate questions regarding potential placebo effects of acupuncture or placebo effects of sham acupuncture procedures that complicate research design in this area. Appropriate placebo or comparison control groups for this type of research need to be identified.