Breast Cancer Prevention: Aromatase Inhibitors American Cancer Society

This hypothesis could be tested by collecting tissues from patients recurring on nonsteroidal AIs and measuring levels of aromatase mRNA, protein, and activity. Aromatase inhibitors (AIs) are approved for use in both early- and advanced-stage breast cancer in postmenopausal women. Although the currently approved “third-generation” AIs all powerfully inhibit estrogen synthesis, they may be subdivided into steroidal and nonsteroidal inhibitors, which interact with the aromatase enzyme differently.

Treatments to stop ovarian function may allow those who haven’t been through menopause to take medicines only available to those who’ve been through menopause. Armidex, Aromasin, and Femara can cause fetal harm and should not be used if there is any chance of pregnancy. As a safeguard, pregnancy testing is recommended seven days prior to the start of treatment if https://xinrenfuyin.org/?p=58161 a woman’s menopausal status is unknown. Breast cancers that lack ERs are called ER negative, and if they lack both ER and PR they may be called HR negative. You might also have calcium and vitamin D supplements to help reduce the effect on your bones.

What is hormone therapy?

Clinical trials have shown that two aromatase inhibitors – anastrozole and exemestane – can lower breast cancer risk in women who have never been diagnosed with the disease. However, these drugs have not yet received FDA approval for this use. Hormone therapy is sometimes used for the neoadjuvant treatment of HR-positive breast cancer in postmenopausal women who cannot tolerate chemotherapy or when surgery needs to be delayed. The hormones estrogen and progesterone are produced by the ovaries in premenopausal women and by some other tissues, including fat and skin, in both premenopausal and postmenopausal women and in men. Estrogen promotes the development and maintenance of female sex characteristics and the growth of long bones.

The type of surgery you have is calledlaparoscopic oophorectomy. When you stop having the drug, your ovaries should start working again. But, if you’re close to the age at which your menopause would naturally start, your periods might not return.

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For that reason, aromatase inhibitors are the preferred treatment for post-menopausal women with estrogen-fueled breast cancers. Aromatase inhibitor therapy is one of the most effective ways to treat ER-positive breast cancer in people who have gone through menopause. Studies show people who take aromatase inhibitors after breast cancer surgery remain free of breast cancer for five or more years after treatment. Aromatase inhibitor therapy has side effects that may affect your quality of life. If you’re taking an aromatase inhibitor, ask your healthcare provider about ways to reduce side effects so you can continue treatment that helps you live free of breast cancer. The side effects of hormone therapy depend largely on the specific drug or the type of treatment (7).

Similarly, if the tumor cells contain progesterone receptors, the cancer is called progesterone receptor positive (PR or PgR positive). Breast tumors that contain estrogen and/or progesterone receptors are sometimes called hormone receptor positive (HR positive). When considering the androgenic properties of AIs, differential effects on healthy tissue may also affect clinical benefit for breast cancer patients. Work in model systems suggests that exemestane treatment may lead to fewer adverse effects related to bone loss than nonsteroidal AIs because of its androgenicity [40–42].

• You are most likely to have anastrozole or letrozole for 5 years.
• As in earlier sequential therapy studies, patients receiving second-line exemestane treatment had a low response rate (6.7%), although the clinical benefit rate was 31%.
• With that being said, a drug allergy is not common with aromatase inhibitors, affecting less than one out of 10,000 users.
• Aromatase inhibitors also can be used to treat advanced breast cancer.
• Hormone-sensitive breast cancers are fueled by the natural hormones estrogen or progesterone.

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That said, studies show breast cancer can come back as long as 20 years after treatment. If you’re receiving treatment for ER-positive breast cancer, ask your healthcare provider to explain your risk of late recurrence breast cancer. The American Society for Clinical Oncology (ASCO), the National Comprehensive Cancer Network (NCCN) and the U.S. Preventive Services Task Force list exemestane and anastrozole as risk-lowering drug options for postmenopausal women at high risk of breast cancer. Possible side effects of aromatase inhibitors include muscle pain, joint pain and menopausal symptoms (such as hot flashes).

Targeted therapy medicines attack specific chemicals in cancer cells. One approach to hormone therapy is to stop the hormones from attaching to the receptors on the cancer cells. When the hormones can’t access the cancer cells, the cancer’s growth may slow and the cells may die. Hormone therapy is only used for breast cancers that are found to have receptors for the naturally occurring hormones estrogen or progesterone. The long-term effects of aromatase inhibitors are arguably more concerning.

Decisions about the type and duration of adjuvant hormone therapy are complicated and must be made on an individual basis in consultation with an oncologist. Approximately 67%–80% of breast cancers in women are ER positive (1, 2). Approximately 90% of breast cancers in men are ER positive and approximately 80% are PR positive (3). How you have treatment depends on the type of hormone therapy you have. You might choose to have an operation to remove your ovaries instead of having drug treatment to stop them from working.