Aromatase Inhibitors in Older Women with Breast Cancer

Cary P. Gross, M.D.,Associate Professor of Internal Medicine (Primary Care)

Approximately 80,000 women over the age of 65 years are diagnosed with breast cancer in the United States annually, and Aromatase Inhibitor (AI) therapy is rapidly becoming the standard of care for adjuvant therapy in preventing recurrence in the majority of these patients. AI therapy appears to be more effective than previous therapies at preventing recurrence of cancer yet, in practice, is causing adverse effects that lead to reduced medication adherence. AIs, which are supposed to be taken daily for five years for full beneficial effect, can cause muscle aches, and joint stiffness and pain, thus prompting patients to stop their therapy early. Women who participated in the clinical trials that led to FDA approval of AIs tended to be younger patients than those with breast cancer in the typical community setting. Gross and his interdisciplinary colleagues have enrolled older post-menopausal women with breast cancer in this study to evaluate their experiences in a community setting.

Highlighted Study Findings

Dr. Gross’s ongoing study focuses on the musculoskeletal effects of AI therapy in women over age 65, which represents the larger proportion of women diagnosed with breast cancer. Gross and his interdisciplinary colleagues have enrolled older post-menopausal women with breast cancer in this study with follow-up over 2 years in order to evaluate physical functioning and mobility, musculoskeletal symptoms, and the relationship of these side effects to adherence with AI therapy in a typical community health care practice. Information from this study is expected to inform clinicians and patients about potential interventions that could be designed to help patients better tolerate and manage their AI therapy, and adhere to their AI therapy for the full five years.