Breast Cancer Prevention: Aromatase Inhibitors American Cancer Society

You might have this on its own or with other hormone therapy drugs such as tamoxifen or exemestane. In this case, if your breast cancer is oestrogen receptor positive, your doctor might recommend hormone therapy. This treatment won’t get rid of the cancer but can stop it growing orshrink it. The most common way to have hormone therapy for breast cancer is after surgery. The aim of hormone treatment after surgery is to lower the risk of the cancer coming back. Although mostly a concern for people with metastatic breast cancer who get higher doses of bisphosphonates or denosumab, these drugs can cause bone, joint and muscle pain [120,128].

• An enzyme called aromatase takes other hormones and converts them into estrogen.
• When used to lower breast cancer risk, these drugs are typically taken for 5 years.
• In the current study, FUL did not elicit clear antitumor activity in the LTLT xenografts, which is in agreement with earlier findings that the ER-independent LTLT cells were insensitive to FUL [29, 30].
• Breast cancer treatment is most effective when all parts of the treatment plan are followed as prescribed.
• However, about a third of women diagnosed with ER-positive breast cancer will ultimately relapse despite adjuvant tamoxifen with or without chemotherapy (10).

Do Aromatase Inhibitors Help Treat Breast Cancer?

These results were recently updated analysing only those women randomised to 5 years of letrozole vs. placebo. At a median follow-up of 51 months there continues to be a 3% absolute improvement in DFS (18% relative reduction) following letrozole with no improvement in overall survival (27). Two SERMs, tamoxifen and toremifene, are approved to treat metastatic breast cancer. The antiestrogen fulvestrant is approved for postmenopausal women with metastatic ER-positive breast cancer that has spread after treatment with other antiestrogens (10).

Hormone Therapy for Breast Cancer

Most breast cancers are ER positive, and clinical trials have tested whether hormone therapy can be used to prevent breast cancer in women who are at increased risk of developing the disease. Tumors that are hormone insensitive do not have hormone receptors and do not respond to hormone therapy. An aromatase inhibitor (AI) is a type of hormone therapy for cancer. Healthcare providers use Cytomel costs to treat a common breast cancer type. This therapy reduces your risk that breast cancer will come back after surgery. If you’re at an increased risk of a specific breast cancer, taking an aromatase inhibitor may reduce that risk.

Incidence of menopause-related symptoms, new onset of osteoporosis, arthralgias and alopecia (generally minimal to mild) were all higher for women randomised to letrozole compared with placebo. There were some specific quality of life domains which were significantly worse with letrozole, including physical functioning, bodily pain, vitality, vasomotor symptoms and sexuality (30). In a trial comparing neoadjuvant letrozole with tamoxifen, the mammographic complete response rate with letrozole, although very low, was still higher than that observed for tamoxifen (20).

You might have an aromatase inhibitor if you have had the menopause. “While taking them, you can experience a gradual loss of bone density, which in some cases can reach the level of osteoporosis,” Mayer says. It’s recommended you have a dental exam (along with any dental work that needs to be done) before you start treatment with a bisphosphonate or denosumab [10].

Although both aromatase inhibitors and tamoxifen can cause menopausal symptoms such as hot flashes, many of their side effects differ (see the table below). Vaginal dryness that is not ameliorated with lubricants may be treated with poorly absorbed vaginal estrogens, such as oestradiol vaginal rings or tablets. However, a small study showed a significant increase in serum estrogen levels following use of these preparations (64).

Hormone therapy is only used for breast cancers that are found to have receptors for the naturally occurring hormones estrogen or progesterone. Women usually begin the drug after undergoing surgery to remove a breast tumor. They typically remain on the drugs for five to 10 years, depending on how likely the cancer is to return.

Aromatase inhibitors don’t stop the ovaries from making estrogen. If your ovaries are still functioning, aromatase inhibitors will have no effect. Although the FDA has not yet approved aromatase inhibitors for any of these purposes, many believe that supporting research will one day broaden the current treatment recommendations. A 2015 study in the New England Journal of Medicine reported that the use of Aromasin in women on ovary suppression therapy was just as effective in preventing recurrence after five years as tamoxifen. After five years of use, an estimated one of out of every 10 women on aromatase inhibitors will experience a fracture due to drug-induced osteoporosis.