ABSTRACT
Hormonal manipulation is a mainstay of breast cancer treatment. Over the past 30 years, tamoxifen, a selective estrogen agonist/antagonist, has been shown to be effective in preventing breast cancer and in treating early-stage and metastatic disease (1-3). Tamoxifen is active in both premenopausal and postmenopausal patients, but the benefits are restricted to patients whose tumors express hormone receptors, and a percentage of women treated with tamoxifen will ultimately develop recurrent disease. In addition, tamoxifen treatment can have serious, though rare adverse effects, including venous thromboembolic disease, cerebrovascular disease, and endometrial carcinoma. Aromatase inhibition, an alternative hormonal therapy targeting breast cancer cells through estrogen depletion, provides an effective and possibly superior option for postmenopausal women.
