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Risks of Extended AI Use

Posted 9/5/2017

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   Nothing is ever simple in Cancer World. As many of you know, the recommendation for some women with ER positive breast cancers is to stay on an anti-estrogen/hormonal therapy for longer than the standard five years. Some women begin with Tamoxifen and switch at some point to one of the AIs while others are on an AI all along. The question for any one woman is always whether the potential benefit in reduction of a recurrence risk is more important than the potential risks associated with the Aromatase Inhibitor.

  Recent studies indicate that the risks of extended/more than five years of an AI may be more substantial than previously suspected. The associated risks are related to cardio-vascular events and bone fractures--that is, serious concerns. This is an introduction to a good summary from MedScape. The bottom line is that this must be an individual decision and requires at least one conversation with your doctor.

Extended AI Use Linked to CV Events and Bone Fractures

Roxanne Nelson, BSN, RN

Aromatase inhibitors (AIs) are commonly used as adjuvant treatment in breast cancer, and recent studies show greater benefits from extended use of these drugs (beyond the standard 5 years), but a new meta-analysis indicates that extended use is associated with a higher risk for cardiovascular events and bone fractures.
Among patients who received extended AI therapy, 7.0% of patients experienced cardiovascular events compared to 6.0% in control groups, which was a statistically significant percentage (odds ratio [OR] = 1.18, 95% confidence interval [CI], 1.00 - 1.40; P = .05). Bone fractures occurred in 6.3% (vs 4.8% of control patients), which was also statistically significant (OR = 1.34; 95% CI, 1.16 - 1.55; P < .001).
However, the risk for death from causes other than breast cancer was not increased by extended AI use.

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