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Aromatase Inhibitors: Did you decide to go on them or not?
Breast Cancer | Last Active: May 12, 2023 | Replies (1190)Comment receiving replies
I read that 20% of women stop taking an AI inhibitor in the first 2 years. I don't know if they studied the re occurrence rate among those people. I agree that doctors need to support whatever decision we make. I switched to Exemestane from anastrozole, I find the side effect much more tolerable now - I'm hoping to go the full 5 years. Some patients they are keeping them on it for 10 years. I'd like to see the difference in re-occurrence rates in 5 vs. 10 years treatment. I just know the survival rate of metastasized BC is like only 25%.
Replies to "I read that 20% of women stop taking an AI inhibitor in the first 2 years...."
@kathyomaha55 For me, the switching from anastrozole to letrozole and then finally to exemestane has been better. I'm at 1 year down and 9 to go, but I keep telling my husband that I'd love to just quit altogether. I initially had invasive ductal breast cancer and second tumor was neuroendocrine so unfortunately the odds are not good if I go off of the exemestane. I really cannot complain as I have two friends in my support group who have metastatic breast cancer and one just recently died.
I started on Letrozole. Switched after 2years to Exemestane. It is a little kinder to my joints. At times I take a week off, about once a year,to kind of reset. That little break ets me get back to feeling more normal and my doc said is fine to do. I guess it is worth the side effects to increase my likely hood to prevent recurrence. Stage 2b- bi-lateral breast cancer, er +
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I found the following article of interest, published in the medical journal Lancet last December:
"The benefits of the aromatase inhibitor anastrozole for breast cancer prevention in high-risk postmenopausal women extend well beyond the five-year treatment period, according to long-term data from the International Breast Cancer Intervention Study II (IBIS-II) Prevention trial.
"The new data were featured at a press briefing today at the San Antonio Breast Cancer Symposium and simultaneously published in The Lancet.
"Five years of treatment carries on producing continuing benefits right out to 12 years," study cochair Dr. Jack Cuzick of the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University London, said during the briefing.
"From 2003 to 2012, the study enrolled 3,864 postmenopausal women at high risk for breast cancer; 1,920 were randomly assigned to anastrozole (1 mg/day) and 1,944 to placebo for five years, with similar adherence rates (75% for anastrozole and 77% for placebo).
"Results reported in 2013, after a median follow-up of five years, showed a 61% reduction in new breast cancers (from 4.6% with placebo to 1.8% with anastrozole), and a number needed to treat to prevent one breast cancer in the first five years of 36, Dr. Cuzick reported.
"The new long-term data show there continues to be a "significant" 36% reduction in new cancers in years five to 12 (4.4% in women who took placebo five years vs 3.5% in those who took anastrozole), he said. "This is statistically significant in its own right, and although numerically less than in the active treatment period, not significantly so," he added.
"Over the entire 12-year period, there is a 49% risk reduction with five years of anastrozole (from 8.8% with placebo to 5.3% with anastrozole), with a number needed to treat over that 12-year period of 29, "which is substantially bigger than seen with tamoxifen at this stage, where the number needed to treat was 49 to prevent one breast cancer," Dr. Cuzick noted.
"No excess of fractures, other cancers, cardiovascular disease or major adverse events was seen in the extended follow-up."