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The composition of vaginal microbiome in menopause and cancer survivor women changes dramatically leading to genitourinary syndrome of menopause (GSM) in up to 70% of patients. Recent reports suggest that laser therapy may be valuable as a not hormonal therapeutic modality. The aim of the present study was to evaluate the effects of fractional CO2 laser treatment on the vaginal secretory pathway of a large panel of immune mediators, usually implicated in tissue remodeling and inflammation, and on microbiome composition in postmenopausal breast cancer survivors. The Ion Torrent PGM platform and the Luminex Bio-Plex platform were used for microbiome and immune factor analysis. The significant reduction of clinical symptoms and the non-significant changes in vaginal microbiome support the efficacy and safety of laser treatment. Moreover, the high remodeling status in vaginal epithelium is demonstrated by the significant changes in inflammatory and modulatory cytokine patterns. Laser therapy can be used for the treatment of GSM symptoms and does not show any adverse effects. However, further studies will be needed to clarify its long-term efficacy and other effects.

Breast cancer therapy after surgery has been improved in recent years. Adjuvant therapies like aromatase inhibitors are being extensively used among breast cancer survivors. This leaded to cancer related and iatrogenic osteoporosis. Management of these patients needs to be focused and differentiated from the standard age related osteoporosis in women. All guidelines consider mandatory to assess fracture risk periodically in all breast cancer survivors. Risk assessment diagnostic FRAX tool is the most used but it's not born specifically for cancer related osteoporosis. The therapeutic management of this kind of osteoporosis has been studied by different societies. Since breast cancer survivors are at risk of osteopenia and osteoporosis, counseling regarding modifiable risk factors is mandatory and advocated. The beginning of the treatment should be tailored in each patient.