Bibliographic review
Author
Mª José Barrera López
Abstract
Introduction: Breast cancer patients receiving aromatase inhibitors as adjuvant therapy may develop aromatase inhibitor–associated musculoskeletal syndrome in approximately 5–20% of cases, whose most frequent clinical manifestation is carpal tunnel syndrome. Beyond the severity of symptoms experienced by each patient, there is major concern about poor adherence and premature discontinuation of endocrine therapy in up to 20–30% of cases, with consequent negative impact on disease outcomes.
Conventional treatments for carpal tunnel syndrome have important limitations: local corticosteroid injections may lead to metabolic disturbances in susceptible patients, are associated with a substantial rate of symptom recurrence, and do not act on the underlying cause, namely sub synovial fibrosis. Surgery is another therapeutic option but likewise does not modify the underlying pathophysiology. These limitations justify the search for complementary and alternative therapeutic approaches.
Objectives: To describe the relationship between the incidence and prevalence of hormone dependent breast cancer and the routine use of aromatase inhibitors in clinical practice, and the consequent development of Aromatase Inhibitor-Associated Musculoskeletal Syndrome and carpal tunnel syndrome. To explore the pathophysiology of carpal tunnel syndrome and its diagnostic criteria. To explain the mechanisms of action of ozone therapy in this clinical context. To analyze the scientific evidence on the use of ozone in carpal tunnel syndrome in breast cancer patients and to assess the plausibility and safety profile of ozone as a therapeutic strategy in this population.
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