Breast Cancer Prevention: Aromatase Inhibitors American Cancer Society

Healthcare providers use aromatase inhibitors 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. 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. For example, they might be a reasonable option for women who have an increased risk of blood clots and therefore should not take tamoxifen or raloxifene.

Aromatase inhibitors work by reducing the amount of estrogen in your body. It also regulates important processes in your skeletal, cardiovascular and central nervous systems that affect your overall health. Furthermore, 8.1% of patients receiving erdafitinib experienced TRAEs leading to discontinuation, versus 13.4% of those on chemotherapy. The treatment also showed a median progression-free survival (PFS) of 5.6 months versus 2.7 months for chemotherapy, and a confirmed overall response rate (ORR) of 35.3% versus 8.5%. The European Commission (EC) has approved Johnson & Johnsoncompany Janssen-Cilag International’s BALVERSA (erdafitinib) as a treatment for adults with unresectable or metastatic urothelial carcinoma (mUC).

Aromatase inhibitors side effects

Similarly, if the tumor cells contain progesterone receptors, the cancer is called progesterone receptor positive (PR positive or PgR positive).
Tamoxifen is approved for this use regardless of menopausal status.
This keeps estrogen levels down and helps prevent cancer cells from getting the estrogen they can use to grow and spread.
Hormone therapies have been shown to reduce the risk of recurrence and improve survival rates.
Since that’s where most estrogen comes from, aromatase inhibitors are not usually recommended for people with fully functioning ovaries.
While aromatase inhibitors can be an effective part of overall treatment, they’re not for everyone.

That may be why weight gain is such a key risk factor for breast cancer after menopause. The female hormone estrogen is “fuel” for about 80% of breast cancers in women who’ve gone through menopause. A 2018 study in the Journal of Clinical Oncology also noted that the risk of diabetes was 240% greater in women on aromatase inhibitors than in the general population. Although the risk was far lower with tamoxifen, aromatase inhibitors do not pose the risk of thromboembolism (blood clots) or endometrial cancer that tamoxifen does. They only lower estrogen levels in women whose ovaries aren’t making estrogen (such as women who have already gone through menopause).

Aromatase inhibitors contraindications

Unlike tamoxifen and raloxifene, aromatase inhibitors tend to speed up bone thinning, which can lead to osteoporosis. Because of this, doctors often recommend checking bone density before starting one of these drugs. These medications do not affect estrogen production in the ovaries. Since that’s where most estrogen comes from, aromatase inhibitors are not usually recommended for people with fully functioning ovaries. A 2020 article in the Journal of Clinical Oncology shows that 79 to 84 percent of breast cancers test positive for estrogen receptors. Aromatase inhibitors are medications that help lower estrogen levels.

Similarly, bisphosphonate drugs like Zometa (zoledronic acid) may help counteract osteopenia, though they increase the risk of osteonecrosis of the jaw. The long-term effects of aromatase inhibitors are arguably more concerning. Unlike tamoxifen, aromatase inhibitors tend to speed up osteopenia (bone loss) in older women who are already at risk of bone problems. As with any medication, aromatase inhibitors can cause side effects and adverse reactions.

In addition, some insurance companies will cover one type of hormone therapy but not another. Check your insurance coverage and discuss your options with your doctor. Below are the pre-insurance, U.S. prices for a month’s supply (30 days) of the brand name and generic versions of tamoxifen and aromatase inhibitors. The lowest costs found using coupons or prescription-assistance programs are also listed. Treatment with tamoxifen for two to five years before aromatase inhibitors may slow down the rate of bone loss.

The breast cancer cells also demonstrate aromatase activity, a likely source of local estrogen for the tumor cells. The inhibition or inactivation of aromatase suppresses serum estrogen levels, which decrease estrogen-mediated cancer cell proliferation in estrogen receptor positive (ER positive) breast cancer 6. Tumors that are hormone insensitive do not have hormone receptors and do not respond to hormone therapy. Two SERMs, tamoxifen and toremifene, are approved to treat metastatic breast cancer.

However, there’s not enough research to conclude that breast cancer patients can replace aromatase inhibitors with grape seed extract or other dietary choices, cautions Proctor. A 2016 study suggests that eating a lot of meats and sugars may contribute to high estrogen levels in postmenopausal women. The researchers recommend weighing the benefits of aromatase inhibitors compared with tamoxifen against these possible risks. A large 2020 study suggests a higher risk of heart failure and death from cardiovascular conditions when taking aromatase inhibitors, compared with the risks of taking tamoxifen. Most estrogen comes from the ovaries, but it’s not the only source.

Breast cancer treatment is most effective when all parts of the treatment plan are followed as prescribed. Women who take an aromatase inhibitor for more than 5 years continue to have side effects while taking the drug, including a higher number of bone fractures and a higher rate of osteoporosis [112, ]. However, overall survival is the same whether a woman takes an aromatase inhibitor for 5 years or 10 years [ ]. For most women, the benefit of the extra 5 years of treatment is small [112]. When an aromatase https://thespiritsgallery.com/2024/05/02/how-steroids-can-help-bodybuilders-improve-their-12/ inhibitor is taken after tamoxifen, the drugs are taken for a combined total of 5-10 years.