Aromasin For Women At High Risk Of Developing Breast Cancer

To evaluate Aromasin for breast cancer prevention in high-risk women, researchers conducted a Phase III trial among 4,560 postmenopausal women. The women had at least one of these breast cancer risk factors:

age greater than 60

five-year risk of breast cancer of more than 1.66% based on the Gail score

prior atypical ductal or lobular hyperplasia, lobular carcinoma in situ, or ductal carcinoma in situ with mastectomy. Study participants received either Aromasin or a placebo.

Risk of invasive breast cancer was 65% lower among women in the Aromasin group than among women in the placebo group. There were 11 invasive breast cancers in the Aromasin group and 32 invasive breast cancers in the placebo group.

Symptoms such as hot flashes, fatigue, sweating, insomnia, and joint pain were common among all study participants, but slightly more so among women treated with Aromasin.

These results suggest that Aromasin may be safe and effective when used to reduce the risk of breast cancer in high-risk women.

Recommendation Guidelines From ASCO Are As Follows:

For Premenopausal Women:

The use of tamoxifen (20 mg per day orally for 5 years) should be discussed as an option to reduce the risk of invasive, estrogen receptor (ER)-positive breast cancer

For Postmenopausal Women:

There are now three options. ASCO strongly recommends that one of the following be considered in order to reduce the risk of invasive, estrogen receptor (ER)-positive breast cancer: Tamoxifen (20 mg per day orally for 5 years) Evista (60 mg per day orally for 5 years) Aromasin (25 mg per day orally for 5 years). (Note: This is a new recommendation, which was based on data from a clinical trial that showed up to a 70 percent reduction in overall and ER-positive invasive breast cancer incidence compared to placebo.)

What's more, the recommendations state that all three agents should be discussed with women aged 35 or older without a personal history of breast cancer who are at increased risk of developing invasive breast cancer, based on risk factors such as age, race, and medical and reproductive history.

Not all women will benefit from the use of these preventive agents. It is important that doctors and women discuss the risks and benefits of each drug in order to determine the best approach. That said, only a small percentage of eligible women have this discussion with their doctors or even consider these medications. As such, the guidelines also stress the need for ongoing research to determine approaches to increase the use of these drugs in women who will benefit from them.