title: Inadvertent use of aromatase inhibitors in patients with breast cancer with residual ovarian function: cases and lessons.
abstract: Aromatase inhibitors (AIs) are important adjunctive therapy for postmenopausal women with hormone receptor-positive, early-stage breast cancer. At the present time, AIs have no role for the management of breast cancer in premenopausal women. We report on several cases of the inadvertent use of AI therapy among women with residual ovarian function. A common experience in these cases was the onset of chemotherapy-related amenorrhea before initiation of AI therapy, which confounded assessment of true menopausal status. We believe clinicians should be aware of the potential ovarian reserve among women with treatment-related amenorrhea so as to avoid use of AI therapy in patients in whom there is uncertainty about menopausal status.
authors.affiliation: Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA. hburstein@partners.org
authors.forename: Harold J
authors.initials: HJ
authors.lastname: Burstein
authors.forename: Erica
authors.initials: E
authors.lastname: Mayer
authors.forename: Ann H
authors.initials: AH
authors.lastname: Patridge
authors.forename: Holly
authors.initials: H
authors.lastname: O'Kane
authors.forename: Georgia
authors.initials: G
authors.lastname: Litsas
authors.forename: Steven E
authors.initials: SE
authors.lastname: Come
authors.forename: Clifford A
authors.initials: CA
authors.lastname: Hudis
authors.forename: Donald F
authors.initials: DF
authors.lastname: Goldstein
authors.forename: Hyman B
authors.initials: HB
authors.lastname: Muss
authors.forename: Eric P
authors.initials: EP
authors.lastname: Winter
authors.forename: Judy E
authors.initials: JE
authors.lastname: Garber
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced; D000970:Antineoplastic Agents / Q000009:adverse effects; D047072:Aromatase Inhibitors; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy*; D000075202:Contraindications; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D008508:Medication Errors; D008875:Middle Aged; D010053:Ovary / Q000502:physiology*; D017697:Premenopause / Q000502:physiology*
chemical_list: D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors; D004958:Estradiol