title: Acute bilateral pulmonary emboli occurring while on adjuvant aromatase inhibitor therapy with anastrozole: Case report and review of the literature.
abstract: Hormonal therapy is the mainstay of adjuvant treatment for women with early-stage estrogen receptor-positive breast cancer. Recently, the aromatase inhibitors have moved to the forefront of adjuvant hormonal therapy, however, the adverse effects of these agents are not yet fully understood. It is generally accepted that tamoxifen, but not the aromatase inhibitors, is associated with an increased risk of thrombosis in women with breast cancer. Studies comparing aromatase inhibitors to tamoxifen in the adjuvant setting have reported a lower rate of venous thromboembolism with the aromatase inhibitors, yet the incidence of venous thromboembolism with these new agents is higher than that expected in the general population. Here we report a case of acute bilateral pulmonary emboli occurring while on adjuvant aromatase inhibitor therapy with anastrozole, and review the literature on the incidence of venous thromboembolism during the use of aromatase inhibitors in the adjuvant setting.
authors.affiliation: Division of Hematology and Medical Oncology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Mailcode L586, Portland, OR 97239, USA. lycettej@ohsu.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Lycette
authors.forename: Shiuh-Wen
authors.initials: SW
authors.lastname: Luoh
authors.forename: Tomasz M
authors.initials: TM
authors.lastname: Beer
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Deloughery
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D000077384:Anastrozole; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D009570:Nitriles / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000139:chemically induced* / Q000453:epidemiology; D014230:Triazoles / Q000009:adverse effects*; D020246:Venous Thrombosis / Q000209:etiology
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077384:Anastrozole