Carbon Dioxide Fractional Laser in Treating Participants With Stage 0-III Hormone Receptor-Positive Breast Cancer With Vulvovaginal Atrophy

PRIMARY OBJECTIVES: I. To evaluate the reduction in Vulvovaginal Symptom Questionnaire (VSQ) score at 3-month follow up after CO2RE laser treatment. SECONDARY OBJECTIVES: I. To evaluate the reduction in VSQ score after CO2RE laser treatment 6-month follow-up and 12-month follow-up. II. To evaluate Female Sexual Function Index (FSFI) score before and after treatment with CO2RE laser. III. To evaluate Urogenital Distress Inventory (UDI) 6 score before and after treatment with CO2RE laser. IV. To evaluate vaginal health index score and vaginal caliber before and after treatment with CO2RE laser. V. To evaluate discomfort and pain during CO2RE laser treatment using the visual analog scale. VI. To evaluate treatment satisfaction after CO2RE laser treatment using 5-point Likert scale. VII. To evaluate adherence to aromatase inhibitor at 6 and 12 months after CO2RE laser treatment. EXPLORATORY OBJECTIVES: I. To assess the change in the vaginal cytology using vaginal maturation index at baseline and during follow-up. II. To assess serum estradiol level at baseline and after CO2RE laser treatment. OUTLINE: Participants undergo carbon dioxide fractional laser therapy over 10-15 minutes on day 1. Treatment repeats every 28 days for up to 3 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, participants are followed up at 3, 6, and 12 months.