Aromatase inhibitors for breast cancer

This table outlines information about the use of aromatase inhibitors in the management of breast cancer. Read this in conjunction with the table "Breast cancer: hormone therapy" for a better understanding of the subject

Aspect	Description
Rationale for Aromatase Inhibitors in Breast Cancer	Aromatase inhibitors are used in breast cancer treatment to reduce levels of oestradiol, which fuels breast tumour growth. Unlike tamoxifen, they indirectly target oestrogen by blocking the conversion of adrenal androgens to oestrogen in peripheral tissues.
Use	Primarily used in postmenopausal women with hormone receptor-positive breast cancer, and also explored in premenopausal patients following ovarian ablation/suppression.
Mechanism of Action	Aromatase inhibitors do not interact with oestrogen receptors directly but inhibit in situ oestrogen synthesis in both tumour and non-malignant breast tissue, effectively reducing oestrogen levels. They come in steroidal (e.g., exemestane) and nonsteroidal (e.g., anastrozole and letrozole) forms.
Main Side Effects	Common side effects include hot flashes, joint disorders, osteoporosis, fractures, bone pain, vaginal dryness, and sexual dysfunction. Less common but severe side effects may include liver function abnormalities, allergic reactions, and ulcers/blisters. The development of arthralgias (joint pain) is a common reason for discontinuing treatment.
Duration of Use	The American Society of Clinical Oncology recommends aromatase...

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