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Vered Stearns, M.D.
Co-Director, Breast Cancer Program
Professor of Oncology
Languages: English, Hebrew
Expertise: Breast Cancer, Medical Oncology
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Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
Appointment Phone: 410-955-8964
401 N. Broadway
Baltimore, MD 21231 map
Co-director, Breast Cancer Program
Professor of Oncology
Co-director, Breast & Ovarian Cancer Research Program
Breast Cancer Research Chair in Oncology, Johns Hopkins School of Medicine
Vered Stearns, M.D., became interested in oncology even before she knew what the word meant. When she was 5 years old, she witnessed her grandfather dying of cancer. She decided then that, when she grew up, she wanted to become a doctor and cure cancer. “While my understanding of oncology has obviously grown more sophisticated, I hope never to lose my childhood enthusiasm for improving the welfare of those afflicted with cancer,” Dr. Stearns says.
During her fellowship, where she first began focusing on breast cancer, Dr. Stearns enjoyed the privilege of working with internationally recognized physician-scientist whom, she recalls, moved seamlessly between the laboratory and clinic. “I was impressed not only with the breadth of their scientific knowledge, but even more so with their ability to translate state-of-the art research into the specific context of patient treatments,” she says.
Dr. Stearns has patterned her own career after these translational physician-scientists. As for her research goals, she aims to further an individualized approach to the prevention, treatment and care for people with or at risk of breast cancer. Already, she has made inroads toward this goal.
Dr. Stearns and her colleagues were the first to evaluate the role of specific cancer-related genetic variants, or mutations, among survivors who had been administered the drug tamoxifen to prevent the re-occurrence of breast cancer. Specifically, they examined the interplay of these genetic mutations in relation to tamoxifen’s metabolism, safety, and efficacy.
Dr. Stearns and her associates now are applying this same principle to evaluate the association between genetic variants and the outcomes of aromatase inhibitors, a class of drugs used to treat breast cancer in post-menopausal women. By evaluating these genetic variants in study subjects, as well as their responses to surveys (related to treatment symptoms) administered several times a year, she and her co-investigators hope to pinpoint factors that will predict which patients are likely to develop side effects from aromatase inhibitors.
The ongoing explosion of knowledge about the molecular basis of cancer, combined with the generosity of patients who continue to commit their time in clinical trials to further scientists’ understanding of breast cancer, make Dr. Stearns optimistic about the future.
“Improvements in bioinformatics will give us more pathways to recognize risk, determine prognosis, and estimate benefits from specific treatments,” she says. “It’s really important for individuals to keep an open mind about what clinical trials might be available, and to talk about that with their physicians. Today’s treatment standards are based on yesterday’s clinical trials.”
- Co-Director, Breast Cancer Program
- Professor of Oncology
Centers & Institutes
- MD, Rutgers - Robert Wood Johnson Medical School (1992)
- MedStar Georgetown University Medical Center / Internal Medicine (1995)
- MedStar Georgetown University Medical Center / Medical Oncology (1997)
- American Board of Internal Medicine / Medical Oncology (1997, 2007)
Research & Publications
Dr. Stearns evaluates and treats men and women with breast cancer of all stages. She has special interest in women with primary tumors for which treatment with preoperative chemotherapy may be appropriate. Dr. Stearns is also interested in evaluating and counseling women who suffer bothersome side effects from to hormonal therapies that are used to treat or prevent breast cancer.
Clinical Trial Keywordsbreast cancer
Selected PublicationsResearch Summary
Novel drug investigation is generally reserved for patients with advanced malignancies or for whom effective treatments are not available, but this may not be the best testing strategy. In early breast cancer, effective therapies are available. However, many women still suffer recurrences and die of their disease, emphasizing the need for new treatments. To test the effectiveness of new therapies in the adjuvant setting, thousands of study participants and many years of follow-up are required. Dr. Stearnss long-term research goal is to establish a clinical model to evaluate sensitivity or resistance to standard and novel anticancer therapies utilizing surrogate markers as endpoints in early breast cancer. Evaluation of baseline and change in surrogate markers of response (such as novel breast imaging and tissue and serum molecular markers) in women who receive preoperative therapy for their breast cancer will allow for clinical trials that require fewer participants and shorter follow-up compared with standard adjuvant trials. Dr. Stearnss trials focus on agents that target and reverse epigenetic modifications.
In other studies, Dr. Stearns examines effects of agents that may prevent breast cancer on surrogate markers that may influence risk of breast cancer (e.g., breast density, circulating estrogens) and the effectiveness of the drug. Agents under investigation include the aromatase inhibitor anastrozole and cholesterol-lowering statins. This work will set the stage for evaluation of novel agents that may prevent breast cancer. The long-term goal of the investigation is not only to improve outcomes of breast cancer patients, but also to set the stage for individualized therapies for breast cancer.
Dr. Stearns is dedicated not only to improving current treatment for breast cancer, but also to enhancing the quality of life of women who survived their disease. Dr. Stearns has conducted several trials evaluating interventions to ameliorate hot flashes and musculo-skeletal symptoms, which are common in women who are taking hormonal therapies to control or prevent breast cancer. At the same time, in collaboration with colleagues at Indiana University and several other academic centers through the NIH-funded Pharmacogenetics Network, Dr. Stearns is also evaluating the role of Pharmacogenetics in predicting effectiveness or side effects to these hormonal interventions. Her work has led to the understanding that genetic variants in the CYP2D6 gene may be associated with a reduced benefit from tamoxifen.
Bao, T.; Prowell, T.; Stearns, V. Chemoprevention of breast cancer: tamoxifen, raloxifene, and beyond. American journal of therapeutics. 2006 Jul-Aug;13(4):337-348.
Borges, S.; Desta, Z.; Li, L.; Skaar, T.C.; Ward, B.A.; Nguyen, A.; Jin, Y.; Storniolo, A.M.; Nikoloff, D.M.; Wu, L.; Hillman, G.; Hayes, D.F.; Stearns, V.; Flockhart, D.A. Quantitative effect of CYP2D6 genotype and inhibitors on tamoxifen metabolism: implication for optimization of breast cancer treatment. Clin Pharmacol Ther. 2006 Jul;80(1):61-74.
Jacene, H.A.; Ishimori, T.; Engles, J.M.; Leboulleux, S.; Stearns, V.; Wahl, R.L. Effects of pegfilgrastim on normal biodistribution of 18F-FDG: preclinical and clinical studies. J Nucl Med. 2006 Jun;47(6):950-956.
Jacene, H.A.; Stearns, V.; Wahl, R.L. Lymphadenopathy resulting from acute hepatitis C infection mimicking metastatic breast carcinoma on FDG PET/CT. Clinical nuclear medicine. 2006 Jul;31(7):379-381.
Kaufmann, M.; Hortobagyi, G.N.; Goldhirsch, A.; Scholl, S.; Makris, A.; Valagussa, P.; Blohmer, J.U.; Eiermann, W.; Jackesz, R.; Jonat, W.; Lebeau, A.; Loibl, S.; Miller, W.; Seeber, S.; Semiglazov, V.; Smith, R.; Souchon, R.; Stearns, V.; Untch, M.; von Minckwitz, G. Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: an update. J Clin Oncol. 2006 Apr 20;24(12):1940-1949.
Prowell, T.M.; Stearns, V. Disease-free survival was greater with letrozole than tamoxifen in postmenopausal women with early breast cancer. ACP journal club. 2006 Jul-Aug;145(1):11.
Prowell, T.M.; Stearns, V.; Trock, B. Lipophilic statins merit additional study for breast cancer chemoprevention. J Clin Oncol. 2006 May 1;24(13):2128-2129; author reply 2129.
Stearns, V. Raloxifene and tamoxifen had similar efficacy for preventing invasive breast cancer in women at increased risk. ACP journal club. 2006 Nov-Dec;145(3):72.
Stearns, V. More choices, more questions: weighing the options for treating hot flashes. The journal of supportive oncology. 2006 Jul-Aug;4(7):323-325.
Stearns, V. Serotonergic agents as an alternative to hormonal therapy for the treatment of menopausal vasomotor symptoms. Treatments in endocrinology. 2006;5(2):83-87.
Stearns, V.; Schneider, B.; Henry, N.L.; Hayes, D.F.; Flockhart, D.A. Breast cancer treatment and ovarian failure: risk factors and emerging genetic determinants. Nat Rev Cancer. 2006 Nov;6(11):886-893.
Wolff, A.C.; Jones, R.J.; Davidson, N.E.; Jeter, S.C.; Stearns, V. Myeloid toxicity in breast cancer patients receiving adjuvant chemotherapy with pegfilgrastim support. J Clin Oncol. 2006 May 20;24(15):2392-2394; author reply 2394-2395.
Briest, S.; Stearns, V. Chemotherapeutic Strategies for advanced breast cancer. Oncology (Williston Park). 2007 Oct;21(11):1325-1335; discussion 1338, 1340.
Elkins, G.; Marcus, J.; Stearns, V.; Hasan Rajab, M. Pilot evaluation of hypnosis for the treatment of hot flashes in breast cancer survivors. Psycho-oncology. 2007 May;16(5):487-492.
Kaufmann, M.; von Minckwitz, G.; Bear, H.D.; Buzdar, A.; McGale, P.; Bonnefoi, H.; Colleoni, M.; Denkert, C.; Eiermann, W.; Jackesz, R.; Makris, A.; Miller, W.; Pierga, J.Y.; Semiglazov, V.; Schneeweiss, A.; Souchon, R.; Stearns, V.; Untch, M.; Loibl, S. Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: new perspectives 2006. Ann Oncol. 2007 Dec;18(12):1927-1934.
Ouwerkerk, R.; Jacobs, M.A.; Macura, K.J.; Wolff, A.C.; Stearns, V.; Mezban, S.D.; Khouri, N.F.; Bluemke, D.A.; Bottomley, P.A. Elevated tissue sodium concentration in malignant breast lesions detected with non-invasive 23Na MRI. Breast Cancer Res Treat. 2007 Dec;106(2):151-160.
Prowell, T.M.; Stearns, V. Extended adjuvant therapy for breast cancer-how much is enough? J Natl Cancer Inst. 2007 Dec 19;99(24):1825-1827.
Stearns, V. Clinical update: new treatments for hot flushes. Lancet. 2007 Jun 23;369(9579):2062-2064.
Stearns, V.; Zhou, Q.; Davidson, N.E. Epigenetic regulation as a new target for breast cancer therapy. Cancer Invest. 2007 Dec;25(8):659-665.
Stebbing, J.; Stearns, V.; Davidson, N.E. Role of CYP2D6 testing in selection of endocrine therapy for breast cancer. Pharmacogenomics. 2007 Jan;8(1):1-3.
Briest, S.; Stearns, V. Adjuvant aromatase inhibitors and emerging quality-of-life considerations. Expert review of anticancer therapy. 2008 Jan;8(1):1-4.
Hayes, D.F.; Stearns, V.; Rae, J.; Flockhart, D. A model citizen? Is tamoxifen more effective than aromatase inhibitors if we pick the right patients? J Natl Cancer Inst. 2008 May 7;100(9):610-613.
Henry, N.L.; Giles, J.T.; Ang, D.; Mohan, M.; Dadabhoy, D.; Robarge, J.; Hayden, J.; Lemler, S.; Shahverdi, K.; Powers, P.; Li, L.; Flockhart, D.; Stearns, V.; Hayes, D.F.; Storniolo, A.M.; Clauw, D.J. Prospective characterization of musculoskeletal symptoms in early stage breast cancer patients treated with aromatase inhibitors. Breast Cancer Res Treat. 2008 Sep;111(2):365-372.
Henry, N.L.; Giles, J.T.; Stearns, V. Aromatase inhibitor-associated musculoskeletal symptoms: etiology and strategies for management. Oncology (Williston Park). 2008 Nov 15;22(12):1401-1408; discussion 1416, 1424, 1426.
Henry, N.L.; Stearns, V.; Flockhart, D.A.; Hayes, D.F.; Riba, M. Drug interactions and pharmacogenomics in the treatment of breast cancer and depression. Am J Psychiatry. 2008 Oct;165(10):1251-1255.
Hickey, M.; Saunders, C.; Partridge, A.; Santoro, N.; Joffe, H.; Stearns, V. Practical clinical guidelines for assessing and managing menopausal symptoms after breast cancer. Ann Oncol. 2008 Oct;19(10):1669-1680.
Jin, Y.; Hayes, D.F.; Li, L.; Robarge, J.D.; Skaar, T.C.; Philips, S.; Nguyen, A.; Schott, A.; Hayden, J.; Lemler, S.; Storniolo, A.M.; Flockhart, D.A.; Stearns, V. Estrogen receptor genotypes influence hot flash prevalence and composite score before and after tamoxifen therapy. J Clin Oncol. 2008 Dec 20;26(36):5849-5854.
Ntukidem, N.I.; Nguyen, A.T.; Stearns, V.; Rehman, M.; Schott, A.; Skaar, T.; Jin, Y.; Blanche, P.; Li, L.; Lemler, S.; Hayden, J.; Krauss, R.M.; Desta, Z.; Flockhart, D.A.; Hayes, D.F. Estrogen receptor genotypes, menopausal status, and the lipid effects of tamoxifen. Clin Pharmacol Ther. 2008 May;83(5):702-710.
Snyder, C.F.; Garrett-Mayer, E.; Brahmer, J.R.; Carducci, M.A.; Pili, R.; Stearns, V.; Wolff, A.C.; Dy, S.M.; Wu, A.W. Symptoms, supportive care needs, and function in cancer patients: how are they related? Qual Life Res. 2008 Jun;17(5):665-677.
Stearns, V. A diet low in fat and high in vegetables, fruit, and fiber following breast cancer treatment did not reduce new breast cancer events. ACP journal club. 2008 Jan-Feb;148(1):8.
Stearns, V.; Rae, J.M. Pharmacogenetics and breast cancer endocrine therapy: CYP2D6 as a predictive factor for tamoxifen metabolism and drug response Expert Rev Mol Med. 2008;10:e34.
Balmanoukian, A.; Zhang, Z.; Jeter, S.; Slater, S.; Armstrong, D.K.; Emens, L.A.; Fetting, J.H.; Wolff, A.C.; Davidson, N.E.; Jacobs, L.; Lange, J.; Tsangaris, T.N.; Zellars, R.; Gabrielson, E.; Stearns, V. African American women who receive primary anthracycline- and taxane-based chemotherapy for triple-negative breast cancer suffer worse outcomes compared with white women. J Clin Oncol. 2009 Aug 1;27(22):e35-37; author reply e38-39.
Bao, T.; Fetting, J.; Mumford, L.; Zorzi, J.; Shahverdi, K.; Jeter, S.; Herlong, F.; Stearns, V.; Lee, L. Severe prolonged cholestatic hepatitis caused by exemestane. Breast Cancer Res Treat. 2009 Oct 16.
Briest, S.; Stearns, V. Tamoxifen metabolism and its effect on endocrine treatment of breast cancer. Clin Adv Hematol Oncol. 2009 Mar;7(3):185-192.
Emens, L.A.; Asquith, J.M.; Leatherman, J.M.; Kobrin, B.J.; Petrik, S.; Laiko, M.; Levi, J.; Daphtary, M.M.; Biedrzycki, B.; Wolff, A.C.; Stearns, V.; Disis, M.L.; Ye, X.; Piantadosi, S.; Fetting, J.H.; Davidson, N.E.; Jaffee, E.M. Timed sequential treatment with cyclophosphamide, doxorubicin, and an allogeneic granulocyte-macrophage colony-stimulating factor-secreting breast tumor vaccine: a chemotherapy dose-ranging factorial study of safety and immune activation. J Clin Oncol. 2009 Dec 10;27(35):5911-5918.
Higgins, M.J.; Rae, J.M.; Flockhart, D.A.; Hayes, D.F.; Stearns, V. Pharmacogenetics of tamoxifen: who should undergo CYP2D6 genetic testing J Natl Compr Canc Netw. 2009 Feb;7(2):203-213.
Higgins, M.J.; Stearns, V. Understanding resistance to tamoxifen in hormone receptor-positive breast cancer. Clin Chem. 2009 Aug;55(8):1453-1455.
Loprinzi, C.L.; Diekmann, B.; Novotny, P.J.; Stearns, V.; Sloan, J.A. Newer antidepressants and gabapentin for hot flashes: a discussion of trial duration. Menopause. 2009 Sep-Oct;16(5):883-887.
Lynn Henry, N.; Rae, J.M.; Li, L.; Azzouz, F.; Skaar, T.C.; Desta, Z.; Sikora, M.J.; Philips, S.; Nguyen, A.T.; Storniolo, A.M.; Hayes, D.F.; Flockhart, D.A.; Stearns, V. Association between CYP2D6 genotype and tamoxifen-induced hot flashes in a prospective cohort. Breast Cancer Res Treat. 2009 Oct;117(3):571-575.
Mohla, S.; Stearns, V.; Sathyamoorthy, N.; Rosenfeld, M.G.; Nelson, P. The biology of hormone refractory breast and prostate cancer: An NCI workshop report. Cancer Biol Ther. 2009 Nov;8(21):1975-1985.
Otte, J.L.; Flockhart, D.; Hayes, D.; Storniolo, A.M.; Stearns, V.; Schneider, B.; Henry, N.L.; Azzouz, F.; Nguyen, A.; Lemler, S.; Hayden, J.; Jeter, S.; Wright, L.; Carpenter, J.S. Comparison of subjective and objective hot flash measures over time among breast cancer survivors initiating aromatase inhibitor therapy. Menopause. 2009 Jul-Aug;16(4):653-659.
Rae, J.M.; Sikora, M.J.; Henry, N.L.; Li, L.; Kim, S.; Oesterreich, S.; Skaar, T.C.; Nguyen, A.T.; Desta, Z.; Storniolo, A.M.; Flockhart, D.A.; Hayes, D.F.; Stearns, V. Cytochrome P450 2D6 activity predicts discontinuation of tamoxifen therapy in breast cancer patients. Pharmacogenomics J. 2009 Aug;9(4):258-264.
Shen, W.; Stearns, V. Treatment strategies for hot flushes. Expert Opin Pharmacother. 2009 May;10(7):1133-1144.
Snyder, C.F.; Garrett-Mayer, E.; Blackford, A.L.; Brahmer, J.R.; Carducci, M.A.; Pili, R.; Stearns, V.; Wolff, A.C.; Dy, S.M.; Wu, A.W. Concordance of cancer patients' function, symptoms, and supportive care needs. Qual Life Res. 2009 Oct;18(8):991-998.
Zellars, R.C.; Stearns, V.; Frassica, D.; Asrari, F.; Tsangaris, T.; Myers, L.; DiPasquale, S.; Lange, J.R.; Jacobs, L.K.; Emens, L.A.; Armstrong, D.K.; Fetting, J.H.; Garrett-Mayer, E.; Davidson, N.E.; Wolff, A.C. Feasibility trial of partial breast irradiation with concurrent dose-dense doxorubicin and cyclophosphamide in early-stage breast cancer. J Clin Oncol. 2009 Jun 10;27(17):2816-2822.
Bardia, A.; Stearns, V. Personalized tamoxifen: a step closer but miles to go. Clin Cancer Res. 2010 Sep 1;16(17):4308-4310.
Bardia, A.; Stearns, V. Personal breast: customizing agents and biomarkers for optimal adjuvant endocrine therapy. Breast Cancer Res Treat. 2010 Apr;120(2):437-439.
Borges, S.; Desta, Z.; Jin, Y.; Faouzi, A.; Robarge, J.D.; Philips, S.; Nguyen, A.; Stearns, V.; Hayes, D.; Rae, J.M.; Skaar, T.C.; Flockhart, D.A.; Li, L. Composite functional genetic and comedication CYP2D6 activity score in predicting tamoxifen drug exposure among breast cancer patients. J Clin Pharmacol. 2010 Apr;50(4):450-458.
Burstein, H.J.; Prestrud, A.A.; Seidenfeld, J.; Anderson, H.; Buchholz, T.A.; Davidson, N.E.; Gelmon, K.E.; Giordano, S.H.; Hudis, C.A.; Malin, J.; Mamounas, E.P.; Rowden, D.; Solky, A.J.; Sowers, M.R.; Stearns, V.; Winer, E.P.; Somerfield, M.R.; Griggs, J.J. 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 Aug 10;28(23):3784-3796.
Chumsri, S.; Jeter, S.; Jacobs, L.K.; Nassar, H.; Armstrong, D.K.; Emens, L.A.; Fetting, J.H.; Lange, J.R.; Riley, C.; Tsangaris, T.N.; Wolff, A.C.; Zellars, R.; Zhang, Z.; Stearns, V. Pathologic complete response to preoperative sequential doxorubicin/cyclophosphamide and single-agent taxane with or without trastuzumab in stage II/III HER2-positive breast cancer. Clin Breast Cancer. 2010 Feb;10(1):40-45.
Henry, N.L.; Jacobson, J.A.; Banerjee, M.; Hayden, J.; Smerage, J.B.; Van Poznak, C.; Storniolo, A.M.; Stearns, V.; Hayes, D.F. A prospective study of aromatase inhibitor-associated musculoskeletal symptoms and abnormalities on serial high-resolution wrist ultrasonography. Cancer. 2010 Sep 15;116(18):4360-4367.
Henry, N.L.; Nguyen, A.; Azzouz, F.; Li, L.; Robarge, J.; Philips, S.; Cao, D.; Skaar, T.C.; Rae, J.M.; Storniolo, A.M.; Flockhart, D.A.; Hayes, D.F.; Stearns, V. Lack of association between oestrogen receptor polymorphisms and change in bone mineral density with tamoxifen therapy. Br J Cancer. 2010 Jan 19;102(2):294-300.
Henry, N.L.; Pchejetski, D.; A'Hern, R.; Nguyen, A.T.; Charles, P.; Waxman, J.; Li, L.; Storniolo, A.M.; Hayes, D.F.; Flockhart, D.A.; Stearns, V.; Stebbing, J. Inflammatory cytokines and aromatase inhibitor-associated musculoskeletal syndrome: a case-control study. Br J Cancer. 2010 Jul 27;103(3):291-296.
Higgins, M.J.; Stearns, V. CYP2D6 polymorphisms and tamoxifen metabolism: clinical relevance. Curr Oncol Rep. 2010 Jan;12(1):7-15.
Jacobs, L.; Sukumar, S.; Stearns, V. Intraductal therapy for the prevention of breast cancer. Curr Opin Investig Drugs. 2010 Jun;11(6):646-652.
Jacobs, M.A.; Stearns, V.; Wolff, A.C.; Macura, K.; Argani, P.; Khouri, N.; Tsangaris, T.; Barker, P.B.; Davidson, N.E.; Bhujwalla, Z.M.; Bluemke, D.A.; Ouwerkerk, R. Multiparametric magnetic resonance imaging, spectroscopy and multinuclear ((2)(3)Na) imaging monitoring of preoperative chemotherapy for locally advanced breast cancer. Acad Radiol. 2010 Dec;17(12):1477-1485.
Kamdem, L.K.; Liu, Y.; Stearns, V.; Kadlubar, S.A.; Ramirez, J.; Jeter, S.; Shahverdi, K.; Ward, B.A.; Ogburn, E.; Ratain, M.J.; Flockhart, D.A.; Desta, Z. In vitro and in vivo oxidative metabolism and glucuronidation of anastrozole. Br J Clin Pharmacol. 2010 Dec;70(6):854-869.
Pathiraja, T.N.; Stearns, V.; Oesterreich, S. Epigenetic regulation in estrogen receptor positive breast cancer-role in treatment response. J Mammary Gland Biol Neoplasia. 2010 Mar;15(1):35-47.
Snyder, C.F.; Blackford, A.L.; Brahmer, J.R.; Carducci, M.A.; Pili, R.; Stearns, V.; Wolff, A.C.; Dy, S.M.; Wu, A.W. Needs assessments can identify scores on HRQOL questionnaires that represent problems for patients: an illustration with the Supportive Care Needs Survey and the QLQ-C30. Qual Life Res. 2010 Aug;19(6):837-845.
Stearns, V.; Davidson, N.E. Adjuvant chemoendocrine thearpy. In: Harris; Lippman; Morrow; Osborne, editors, Diseases of the Breast, 4th Edition Philadelphia: Lippincott
WilliamsWilkins; 2010. p. pp 645-656.
Rand, K.L.; Otte, J.L.; Flockhart, D.; Hayes, D.; Storniolo, A.M.; Stearns, V.; Henry, N.L.; Nguyen, A.; Lemler, S.; Hayden, J.; Jeter, S.; Carpenter, J.S. Modeling hot flushes and quality of life in breast cancer survivors. Climacteric. 2011 Feb;13(6):171-180.