A new way to prevent breast cancer: anastrozole

I had a lumpectomy. Cancer was not found in my lymph node. I had stage one. I took letrizole for about 9 months and was taken off of it because of itching in my scalp, neck and ear area. The itching started 2 or 3 months before I was taken off of it. Then the rash moved to include more areas. Now I am told that they will put me on Anastrozole and that it might also cause me to itch. That bothered me but now that I read about hair loss and anaphylactic reactions I am even more sad. I have good hair. It’s thick and long even if I am in my late sixties. I get compliments on it. My chances of the cancer returning were 3 % with the letrzole we’re 3% . I guess it will be similar with anatrazole. Gee, this isn’t good. Wish I had not been allergic. Do drs. Answer questions here. I appreciate patients comments also. Thank and good luck with your treatment.

Stage 1 adenocarcinoma 1/2008, lumpectomy, mammosite radiation and ACT chemo. Started on Arimidex but could not tolerate the severe joint and bone pain. Switched to Femara (letrozole) 2 mg/daily and could not tolerate severe joint and bone pain. Started seeing a rheumatologist whose own mother had been treated for breast cancer and subsequently put on aromatase inhibitors. When the side effects are severe, they are severe and intolerable. Quality of life is extremely poor. She understood all of this from watching her mother go through this treatment and she had to make a medical decision to remove her mother from these drugs. I considered it but decided to try to stick it out for the five years that were recommended at that time. It took 3 muscle relaxants/day, two large doses of NSAIDS/day, two large doses of CoQ10/day and my life was tolerable. I did stop this medication twice for a total period of a year so I actually was on it for six years (with two six month hiatuses). I have been informed that the studies indicate that I should probably stay on it for life, but I cannot contemplate that possibility at this time when I am only off the medication for a little over a month. The problem is that all the other medication I was taking to help with those side effects are causing liver issues and I have to get off them. For me, it’s a trade off–prevent cancer or live a life of excruciating pain and immobility. I’m going to reexamine this at the six month anniversary and decide at that time if I can tolerate taking this drug again. As I said, when a patient has side effects that are not “moderate” (which is how it was described to me prior to taking it), those side effects are severe and life-altering. It’s a dilemma I wish I had the answer to.

Attn: Martin Ledwick; My wife is 70. She had a lumpectomy followed by radiotherapy 5 years ago (2 lymph nodes were OK). She was put on FEMARA tablets but found the leg/joint pains severe. She was switched to ANTASTROZOLE (ARIMIDEX). These have had less side effects but still bad. She takes paracetamol/codine almost daily to easy pain and takes joint supplements. From a fit person she now has difficulty standing/walking for any period. She has now reached 4.5 years on the scheduled 5 year term on the tablets. When switching from FEMARA to ANASTROZOLE the doctor recommended a break in tablets for around a month between stopping “old” and starting “new” and in that time my wife’s pains reduced and mobility improved. We are considering a long holiday (21 days) to celebrate our joint 70ths and wondered if there was any research/information/advice with regard to stopping the ANASTROZOLE for say a month before and during the holiday (say 2 months in all) to help her enjoy the break more. She would then plan to start them again till then end of term and seek advice from her doctor concerning the future. Is there any information/advice on stop/start approach?

Very informative. I’m a breast cancer survivor for 2 years. My friend who was diagnosed at the same time I was, was just diagnosed with pancreatic cancer. So of coarse my mind started wondering. This article set my mind at ease. Thank you, Kathy Lopez

Wow.. really useful informative blog on breast cancer prevention. We are researching and collecting IBCR repositories with different people experiences. You can visit us at IBCR.

I took part in trials of Tamoxifen and Letrozole about 10 years ago and I had the opportunity to continue taking either one. I have been taking Letrozole for 10 years now I do have side effects, Osteoporosis in my spine and am taking bisphosponhates which seem to be having a positive holding effect. I also suffer from regular urinary track infections and I also continue to have hot flushes and night sweats. But I really believe that taking Letrozole is preventing cancer returning in the other breast and metastases, so hopefully I will continue taking it as long as possible

Hi, have been taking Letrozole daily since August 2011 after right breast mastectomy and
sentinel lymph node biopsy. HER2 neg. ER positive 8/8. When will we have results on
research into Letrozole. No side effects so far, travelling hopefully!

In 2000 I had a lumpectomy and several lymph glands removed followed by radiotherapy. I was given tamoxifen for 5 years. 2years later the cancer returned and I had another lumpectomy on the other breast. So in 2007 I was given anastrasole. I do not want to come off this as am worried that the breast cancer will return. I have suffered from joint pains but was recommended I take Glucosame, Chondroitin but with MSM which I do and the joints are ok. I am going to insist I keep taking anastrasole as I have also had a full hysterectomy.

Hi Caroline
At the moment Anastrozole would usually be prescribed for 5 years following other treatments for early breast cancer. But a specialist may sometimes suggest taking it for longer in some circumstances. A study looking at taking a different type of hormonal treatment called Tamoxifen that was recently completed suggested that there may be an advantage in taking this drug for 10 years rather than 5, but similar studies have not yet been done looking at aromatase inhibitors. And it is always important to balance any longer term side effects of treatment with potential benefits. If you have concerns talk them through with your specialist.

Martin Ledwick, Head Information Nurse, Cancer Research UK

Hi Wendy
So far the studies on using Anastrozole to prevent breast cancer in women who haven’t been diagnosed but are considered to be at high risk have only looked at giving it for 5 years. As these women have never had breast cancer (and may never get it) but are at increased risk, the researchers have to be particularly careful to avoid any long term side effects of it that may outweigh any benefits. At the moment the women in the trial have only been followed up on average for 5 years following completing the course of treatment, so it is not yet known if the increased risk returns after 5 years have elapsed. However, a similar study using a different hormonal treatment called Tamoxifen seemed to have a benefit that lasted for 10 years following completeion of 5 years treatment, so it is quite possible that the benefits last longer than the course of treatment.

In women who are taking Anastrozole to stop a recurrence of breast cancer after being diagnosed with it, the current recommendation is also 5 years, but this may change as more research evidence becomes available.

Martin Ledwick, Head Information Nurse, Cancer Research UK

Hi Heather
At the moment, for early breast cancer (breast cancer that has not spread to other parts of the body) Anastrozole is usually prescribed for 5 years, but in some circumstances your specialist may opt to carry it on for longer.
In your situation this may have been because you were younger when the cancer first developed and quite a number of your lymph nodes were affected. As more research is done it is possible that guidance may change on how long to take it for, but at the moment for cancers that have not spread there is not yet any clear evidence of benefit of taking it long term. As there can be longer term side effects for taking Anastrozole your specialist would need to balance the risks of taking it for longer against potential benefits which at the moment may not be known. If you have any further questions it may help to give our nurse team a call on freephone 0808 800 4040.

Martin Ledwick, Head Information Nurse, Cancer Research UK

Hi Alice Heffernan
Generally, if a breast tumour is considered hormone receptor negative, treatments which prevent the action of hormones on the tumour like Tamoxifen and Anastrozole are not thought to be as effective. But, if your cancer ever did recur, or you developed a new breast cancer, your doctors might reassess the situation to see if hormonal treatments might be useful.

Martin Ledwick, Head Information Nurse, Cancer Research UK

I had a bi-lateral mastectomy, Grade 3 and 10 positive lymph nodes removed in 2003. Six months of chemotherapy (Taxol) and radiotherapy. Two years on Tamoxifen then was changed to Anastrozole. My oncologist has agreed to me taking Anastrozole indefinitely as I was a high risk cancer patient. Although there are no statistics for people who have taken Anastrozole for this length of time I am prepared to take the risk as I hope this will prevent a recurrence. Suffer some joint pain particularly in the feet.

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I have been taking anastozole for 7 years previously taken Tamoxifen for 5 years, Was diagnosed with breast cancer stage 3 at age 38 with DCIS -and had tumour 2.5cm with 27 lymph nodes affected had mastectomy followed by 8 months chemo and 8 weeks radiotherapy. Would it be beneficial to stay on Anastrozole I have been told now to stop. Experienced minimal side effects hot flushes and slight joint pain. My consultant thinks it best to stop now was wondering would it be best to continue to stop any re-occurrence.

But what happens after 5 years when you stop taking the pills? Are you at less risk or back to how you were at the beginning? No one seems to know.

I finished taking Anastozole last year after a 5 year period following treatment for Breast Cancer. I had a Lumpectomy, Chemotherapy and Radiotherapy. I did suffer with dreadful night sweats and Hot Flushes but managed to cope ok. I was wondering if it would be beneficially to continue with this treatment to avoid a possible re-occurence? I do have a Family History and both myself and my sister were 42 and 44 when diagnosed.

This is very exciting, I’m on anastozole for five years following breast cancer. I have 2 more years to go. However, I get horrible side effects such as burning hot flushes and sweats which come with pounding heart and head, osteoporosis, very aching bones and muscle, severe insomnia and have had to cut my work hours to 16 per week through lack of stamina, I am 60 but am greatful that hopefully this drug will cut my chance of cancer coming back.

I was diagnosed with Breast cancer in October 2012 and have received surgery (lumpectomy and removal of two lymph nodes) followed by radiotherapy. I took anastrazole and had joint pains and dental pain, I was switched to tamoxifen and had nausea and psychological side effects and finally I too exemestane which also gave me joint pains, nausea and psychological problems. With the consent of my oncologist, I am no longer taking medication. However, my existing gum disease has progressed to a serious extent and I have just had to have dental surgery prior to implants which was not required prior to the hormome treatment. My dentist, who is an experienced implant surgeon stated that he had not seen any bone disease as bad as mine. This does not appear to be a recognised side-effect but I do know that, within 48 hours of stopping the exemestane, the dental pain resolved, although obviously, the damage had already been done. I also had a number of epuli on my gums which have also cleared up.

This is exciting news. I had a mastectomy 10 years ago, followed by 6 months of chemotherapy treatment. Because my cancer was receptor negative I was told that Tamoxifen wouldn’t have helped. Is Anastrozole also not used in cases such as mine?

As I have been taking Tamoxifen for almost 5 years following lumpectomy L breast and radiotherapy, but developed osteoarthritis necessitating L and R hip replacement, I wish to know if there is any data available which would implicate the oestrogen suppressing Tamoxifen as a cause of cartilage breakdown.

My experience of the onset of osteoarthritis at 62 is a unique occurrence in my family. I was not overweight when OA developed and took regular exercise (swimming and walking).

Hi Sheila Reid. Tamoxifen can be a useful treatment for men who develop breast cancer, but there is less research information about how well other hormonal treatments like anastrazole work in men. If a man has a family history of breast cancer, his risk of getting breast cancer (although probably higher than for men without a family history) is still not nearly as high as for women with a family history. So it is less likely that the hormonal preventatives would give these men as strong a benefit. The IBIS trial only looked at preventing breast cancer in women with a family history.

Martin Ledwick, Head Information Nurse, Cancer Research UK

S Ruskin – that’s an interesting point, thank you for your comment. In the IBIS I trial, researchers found slightly higher reduction in the risk of breast cancer for pre-menopausal women compared to post-menopausal women (a 33 per cent reduction in risk for women before menopause and a 23 per cent reduction in risk for those who had been through their menopause).
This suggests that tamoxifen may be particularly useful for women before menopause, when anastrozole can’t be used. It’s important to note that these two drugs have not been tested in a head-to-head trial to compare them thoroughly, but it’s useful to see this figure for context.

Great article, Nikki – interesting, really well written and easy to understand the science

can a man take anastrozole instead of risking the side effects of tamoxifen?

Can you (or the researchers) show the tamoxifen cases without pre-menopausal women to show a more useful comparison? Thanks

ANASTROZOLE.Sounds good,and I’m pleased to say have been taking this since late 2009,so am in my last year of 5 years,post mastectomy and lymph node removal and chemotherapy.Have had point discomfort and hot flushes,but could have been far worse.