Aromatase Inhibitors for Breast Cancer

For some women who have been treated with tamoxifen, changing to an aromatase inhibitor may be recommended at some time depending on her risk of recurrence. Findings from randomized controlled trials have shown the aromatase inhibitors exemestane and anastrozole may lower the risk of developing breast cancer in postmenopausal women at high risk [ ]. Aromatase inhibitors lower estrogen levels in the body by blocking aromatase, an enzyme that converts other hormones into estrogen. This slows or stops the growth of the tumor by preventing the cancer cells from getting the hormones they need to grow.

How is hormone therapy used to treat breast cancer?

Aromatase inhibitor therapy does not affect estrogen production in the ovaries. Read on as we take a closer look at aromatase inhibitors and who can use them. Proving your own costs may be required for the insurance to cover your drug.

• Proving your own costs may be required for the insurance to cover your drug.
• The researchers recommend weighing the benefits of aromatase inhibitors compared with tamoxifen against these possible risks.
• Although both are also used for breast cancer prevention, neither is approved for that indication specifically.
• Aromatase inhibitors are medications that help lower estrogen levels.

What are aromatase inhibitors?

Most people take aromatase inhibitors for five years, stopping treatment if they don’t have signs of recurring or new breast cancer. As an agent to induce ovulation, dosing is 2.5 mg to 5 mg daily for 5 days starting on day 3 of the menstrual cycle. Kidney adjustment is unnecessary if creatinine clearance is above 10. In patients with cirrhosis of the liver, CHild-Pugh Class C, increase the dosing interval to every 48 hours. Depending on your circumstances, you may undergo tests to monitor your medical situation. These tests help watch for cancer recurrence or progression during hormone therapy.

Or doctors may suggest that their postmenopausal patients take an aromatase inhibitor instead of tamoxifen. Certain drugs, including several commonly prescribed antidepressants (those in the category called selective serotonin reuptake inhibitors, or SSRIs), inhibit an enzyme called CYP2D6. This enzyme plays a critical role in the body’suse of tamoxifen because CYP2D6 metabolizes, or breaks down, tamoxifen into molecules, or metabolites, that are much more active than tamoxifen itself.

These tissues are the major source of estrogen after menopause or oopherectomy. Inhibitors of aromatase were developed to block the synthesis of estrogen in the peripheral tissues and, therefore, as antiestrogen therapy of estrogen receptor positive (ER+) breast cancer in postmenopausal women. Estrogen and progesterone also promote the growth of some breast cancers, which are called hormone-sensitive or hormone-dependent breast cancers. Hormone-sensitive breast cancer cells contain proteins called hormone receptors such as estrogen receptors, or ERs, and progesterone receptors, or PRs that become activated when hormones bind to them.

Tamoxifen is approved for this use regardless of menopausal status. A breast cancer that’s sensitive to estrogen is called estrogen receptor positive, also called ER positive. A breast cancer Primobolan that’s sensitive to progesterone is called progesterone receptor positive, also called PR positive. Hormone therapy for breast cancer is only used to treat cancers that are hormone sensitive. Hormone-sensitive breast cancers are fueled by the natural hormones estrogen or progesterone.

Keep Careful Records

Like tamoxifen, these drugs are more often used to treat hormone receptor-positive breast cancer than to lower breast cancer risk. All patients on aromatase inhibitors should have initial routine lab work, including a complete blood count, serum calcium, vitamin D levels, lipid profile, and liver function tests 4, 5. Patients should also have a baseline bone mineral density test (DEXA scan) before initiating the treatment 6, 7. In women, aromatase inhibitors are only used in those who have gone through menopause.