CHEMOPREVENTION
New ASCO (American Society of Clinical Oncology) guidelines recommend Aromasin to reduce the risk in high-risk postmenopausal women.
New ASCO (American Society of Clinical Oncology) guidelines recommend Aromasin to reduce the risk in high-risk postmenopausal women.
ASCO is an organization that provides recommendations to physicians based on reliable research and experience in cancer treatment. ASCO has established new guidelines for hormone therapy in high-risk patients who have not yet been diagnosed with breast cancer. The use of Aromasin (chemical name: exemestane) is recommended for postmenopausal women at high risk of breast cancer to reduce the risk. This is the first time Aromasin has been recommended in this way. The guidelines containing this new recommendation were published in the scientific journal Clinical Oncology on July 8, 2013. See "Link Use of Pharmacologic Interventions for Breast Cancer Risk Reduction: American Society of Clinical Oncology Clinical Practice Guideline." (PDF)
Aromasin works by inhibiting estrogen production in the body, thus limiting the amount of estrogen available to stimulate hormone receptor-positive cells.
In ASCO guidelines published in 2009, doctors recommended Evista (chemical name: raloxifene) only in high-risk patients after menopause and tamocapsifen in pre- or postmenopausal women to reduce risk. Both drugs are approved by the U.S. Food and Drug Administration (FDA) for the prevention of breast cancer.
Evista and its modulator, tamoxifen, are known as SERMs (Selective Estrogen Receptor Modulators). SERMs, as the word "selective" in their name suggests, reduce estrogen activity in specific cells. In contrast, SERMs strengthen bones by increasing estrogen activity in bones. In breast cancer, they block estrogen receptors from interacting with estrogen, thus reducing cell growth.
Aromasin is not approved by the US Food and Drug Administration. Based on research conducted, ASCO experts recommend Aromasin for postmenopausal women at high risk. Research has shown that postmenopausal women who use Aromasin have a 65% lower rate of cancer.
Tamokifen, Evista, and Aromasin are medications taken in pill form.
ASCO experts developed the new guidelines based on a review of studies conducted between June 2007 and July 2012. Key highlights include:
Tamokifen (20 mg daily for 5 years) is effective in treating estrogen receptor-positive high-risk women. It may be considered as an alternative to reduce the risk in women at risk before and after menopause (over 35 years of age). Tamoxifen is not recommended for women with a history of blood clots, strokes, or heart attacks. Tamoxifen is not recommended for women who are pregnant, at risk of pregnancy, or breastfeeding. Women taking hormone replacement therapy (HRT) should also not use tamoxifen.
Evista (60 mg daily for 5 years) may be considered as an alternative to tamoxifen or Evista for high-risk women with estrogen receptor-positive hormones after menopause (over 35 years of age). It should not be used before menopause. Evista is not recommended for women with a history of blood clots, strokes, or heart attacks.
Aromasin (25 mg daily for 5 years) may be considered as an alternative to tamoxifen or Evista for high-risk women with estrogen receptor-positive hormones after menopause (over 35 years of age). It should not be used before menopause.
Tamokifen, Evista, and Aromasin do not reduce the risk of breast cancer in people with hormone-negative hormone receptors.
Tamokifen, Evista, and Aromasin can cause side effects. Some can be serious. Hot flashes and night sweats are common side effects. They are less common with Aromasin, but Aromasin causes more joint pain and weakens bones. Rarely, all three medications can cause serious blood clots, but this effect is less common with Aromasin.
If you have a higher-than-average risk of breast cancer, it's wise to try to keep your risk as low as possible. A lifestyle that includes the following will help you achieve this:
Exercising as much as possible
Avoiding/reducing alcohol consumption
Reducing processed and sugary foods
Eating a healthy diet
Not smoking
You can discuss your medication options and their benefits and risks with your doctor. If you are taking tamoxifen or Evista and are experiencing side effects, ask your doctor if Aromasin is an alternative for you.