Aromatase inhibitors better than tamoxifen at reducing risk of breast cancer recurrence in premenopausal and postmenopausal women Nuffield Department of Population Health

Written by on 14/11/2023 in Uncategorized

Aromatase inhibitors better than tamoxifen at reducing risk of breast cancer recurrence in premenopausal and postmenopausal women Nuffield Department of Population Health

This will usually be from a group of drugs called bisphosphonates. If you’re concerned about this you may find it helpful to speak to your specialist. Breast cancer that has spread to other parts of the body such as the bones, lungs, liver or brain. Also called metastases, advanced breast cancer, secondaries or stage 4 breast cancer.

  • Studies have shown that aromatase inhibitors can decrease oestrogen production in postmenopausal women and are very effective breast cancer treatments.
  • Many side effects can be prevented or controlled with medicines that your doctor can prescribe.
  • It is now well established that oestrogen helps to maintain healthy bones in women (and indeed in men).
  • Anastrozole belongs to a group of medicines called aromatase inhibitors.

These oestrogen receptor-positive breast cancers nowadays make up about 80% of cases. AIs offer an effective treatment option for secondary HR+ breast cancer in post-menopausal women, or in some cases pre-menopausal women and men. Side effects may occur, but open communication with the care team can help patients to manage these challenges and improve outcomes. In pre menopausal women, doctors might use a type of hormone treatment to stop the ovaries from producing oestrogen. These are called luteinising hormone releasing hormone (LHRH) agonists.

Tips to help lower your risk of heart disease and diabetes

This study also showed that after 10 years 15% more patients were alive on aromatase inhibitors vs. tamoxifen. It should also be noted that there were fewer cases of endometrial cancer over 10 years in the aromatase inhibitor group (0.4%) compared to the tamoxifen group (1.2%). However, bone fractures were more common over 5 years in patients on aromatase inhibitors (8.2%) compared to patients on tamoxifen (5.5%). Another paper that compared four studies of approximately 2300 patients with secondary breast cancer similarly showed the benefit of aromatase inhibitors17.

  • This oestrogen is still produced after the menopause and may stimulate breast cancer cells.
  • You may find your side effects reduce after stopping anastrozole, for others they may continue after treatment finishes.
  • “Looking for cancer DNA in the blood allows us to analyse the genetic changes in cancer cells without the need for invasive biopsies.
  • Stopping your aromatase inhibitor will mean that one potential cause of further deterioration to your bones has now been removed.
  • Other targeted therapies include abemaciclib (brand name Verzenios), and palbociclib (brand name, Ibrance).

Commonly used drugs in this family include anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin). are a type of hormone therapy drug used to treat breast cancer in women who have gone through a natural menopause (when periods stop). It can also be used in premenopausal women having ovarian suppression. This report is intended to assess the usefulness of aromatase inhibitors (AIs) as adjuvant systematic therapy in postmenopausal women with early hormone-sensitive breast cancer. Overall this work has changed the way doctors treat oestrogen receptor-positive breast cancers across the world, saving the lives of thousands of women every year, and sparing many from unnecessary chemotherapy. Researchers are also looking into the possibility that tamoxifen may protect against heart problems.

What has been your experience on letrozole?

This works by cutting down the amount of the hormone oestrogen that a patient’s body makes by blocking an enzyme called ‘aromatase’. You might have hormone therapy when secondary breastcancer is first diagnosed. It is also a possible treatment for breast cancer that has spread to other parts of the body.

  • Those on aromatase inhibitors went on for longer without their cancer growing or worsening, in comparison to those on tamoxifen.
  • Also called metastases, advanced breast cancer, secondaries or stage 4 breast cancer.
  • As a combination, exemestane and everolimus have a lot more side-effects than letrozole and palbociclib, and it’s more difficult to point the finger of blame at one or the other!
  • However, this problem may be overcome by using treatments that suppress ovarian function, such as drug therapies or surgery.
  • Initial results from clinical trials suggest that these agents will become the cornerstones of future endocrine therapy.

I am no stranger to the effects of the menopause and lack of oestrogen as I entered the menopause at the age of 56. At that time, the lack of oestrogen was very debilitating, so I wasn’t looking forward to starting letrozole and zoladex, to shut my ovaries down, a double whammy. Generally, it has been fine and nowhere near as bad as my first menopausal experience. Clinical trials have demonstrated that most patients being treated with a CDK 4/6 inhibitor in combination with an AI live around 10 months longer on average, compared to patients being treated with an AI alone7,8,9.

They’re identified using either a combination of a radioisotope and a blue dye, or a magnetic liquid (Magtrace). Your surgeon will always remove an area of healthy breast tissue around the tumour, which will be tested for traces of cancer. Treatment aims to achieve remission, where cancer shrinks or disappears, and you feel able to enjoy a good quality of life. “The Once for Scotland Right Decisions app is a step-change in support for evidence-based health and social care decisions.

This means there’s less oestrogen in the body to help breast cancer cells to grow. Men with breast cancer may be given an aromatase inhibitor, although another drug called tamoxifen is more commonly used. Aromatase inhibitor medicines are used to treat certain types of breast cancer, where the cancer cells need oestrogen (a hormone) to grow.

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If used in younger women with a menopause that was caused by surgery, radiotherapy, goserelin or chemotherapy, bone loss is even more rapid (up to 8 per cent per year). Breast cancer is the most common malignant disease in women, with an annual incidence of 40,000 cases in the UK. Oestrogen receptor positive breast cancer (65% of breast cancers) can be treated with adjuvant endocrine therapy.

Since June of this year (2023), I now alternate between letrozole and exemestane to try and minimise the side effects. I’ve not been on OWise long, but I have found it really useful to log symptoms and how I feel so that I can pinpoint the cause of side effects and check to see if there was a pattern. The licensing work was undertaken by Accord Healthcare on a not-for-profit basis, after Accord Healthcare was selected through an open competitive process. The Medicines Repurposing Programme will now work with the MHRA and the British Generic Manufacturers Association to ensure other companies that make anastrozole adopt the new licensed indication. Weight bearing exercise such as walking can help to build up the bones and protect them.

About the Author

About the Author: I am part of the John Maxwell team and a certified trainer, speaker and coach. I am also a fully accredited minister with the Baptist Union of Great Britain. In addition I am the Lead Pastor of Custom House Baptist Church and one of the District Ministers for London East. I also chair the London Baptist Associations's communications hub and I am part of the London Baptist Association's Strategic Mission Forum. I have a keen interest in all things leadership believing leadership is primary in building influential missional churches. I am married to a wonderful wife and I am blessed with two lovely daughters. .


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