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Acupressure to Self-Manage Aromatase Inhibitor Musculoskeletal Symptoms in Breast Cancer Survivors

Acupressure to Self-Manage Aromatase Inhibitor Musculoskeletal Symptoms in Breast Cancer Survivors identifier:

Quality of Life:
Breast Cancer Survivor

Study Contact Information:

Principal Investigator:
Chao H Yeh, PhD
Johns Hopkins School of Nursing
By phone: 410-502-1084 or by email, or
Mariela Pinedo, MPH  by email or
Sonaali Pandiri, MHA by phone at: 410-614-6023

Auricular Point Acupressure to Self-Manage Aromatase Inhibitor Musculoskeletal Symptoms in Breast Cancer Survivors

About the Study

Severe joint pain and muscle stiffness are common side effects of taking Aromatase Inhibitors.  Aromatase inhibitor musculoskeletal symptoms have a negative effect on a woman's physical function and quality of life.

Auricular point acupressure uses stimulation applied to points on the ear without using needles. This study will look at and test auricular (ear) point acupressure to manage aromatase-inhibitor-caused joint pain and muscle stiffness in breast cancer survivors.

Type of Study

This is a randomized, three-arm, single-blinded study. 

  • In a randomized study, participants are placed into one of multiple study groups by chance. Neither patients nor their research doctor will choose the group in which the participants are placed.
  • The study has three arms.  This means that participants in the study are placed in one of three different groups.
  • The study is a single-blinded study; the participant will not be told which group they have been assigned to. 

What the Study Entails

Participants will be assigned to one of three groups:

  • Auricular Point Acupressure (APA) group: Participants will have small seeds taped to specific points of their ear and will be instructed on applying light touch to them to manage pain and stiffness. The points used will correspond to current body pain location as well as three other points known for alleviating stress and pain. (seeds are placed on adhesive tape, and then applied to the participant’s ears.)
  • Sham APA group: Participants will receive light touch instruction using small seeds on different points of the ear (as compared to the APA group). The five ear points used in the Sham APA group will correspond to mouth, stomach, duodenum, internal ear, and tonsils as these are areas that are normally pain-free for breast cancer survivors. 
  • Education Control group: Participants will receive four, 15-minute weekly individual sessions, reflective of standard medical care per guidelines from the American Society of Clinical Oncology (ASCO) that will include information about hormonal therapy, management of physical long-term effects, management of psychological long-term effects, diet and physical activity.  

Each participant in each group will complete a survey to rate their pain intensity, physical function, physical disability, and physical strength at the following intervals:

  • baseline
  • pre- Intervention (4 weeks)
  • post-intervention (8 weeks)
    • one-month (12 weeks)
    • 2-month (16 weeks) 
    • 3-month (20 weeks)

Study Site

Baltimore, MD
Johns Hopkins School of Nursing
Contact: Chao H Yeh by phone: 410-502-0184  or by email: or 
Contact: Mariela Pinedo, MPH by email:

This Study is Open To:

Women at least 18 years of age can participate if they:

  • Have a history of non-metastatic breast cancer, and are not postmenopausal.
  • Are taking an aromatase inhibitor (anastrozole, letrozole, exemestane) for at least 2 months.
  • Have joint pain attributable to the aromatase inhibitor, or had pre-existing joint pain that worsened after the initiation of the aromatase inhibitor.
  • Are able to apply pressure to the seeds taped to their ears.
This Study is Not Open To:

Women are excluded if they have:

  • Metastatic breast cancer.
  • Completed chemotherapy or radiation less than 4 weeks prior to study enrollment.
  • Had bone fracture/surgery during the preceding 6 months.
  • Are currently using corticosteroids or narcotics.
  • An ear skin disease or have piercings on the ear points that would be used for treatment.
  • Had previous auricular therapy.