Section 5
Clinical Use of Aromatase Inhibitors

AROMATASE INHIBITORS AS PRIMARY OR NEOADJUVANT THERAPY

I have a select group of elderly patients — patients in their eighties to nineties — where all we’re doing is endocrine therapy. These are cases where the surgeons aren’t even very excited about doing a lumpectomy, so I use tamoxifen and now, more recently, aromatase inhibitors, and they’re doing fine. There’s also a huge literature — mainly in Europe — of primary tamoxifen therapy, but it’s not my choice in a healthy patient.

As neoadjuvant therapy, I have had a few older patients with ER-positive disease in whom I’ve used aromatase inhibitors, and some have been successful in allowing lumpectomy. Aromatase inhibitors look as good as chemotherapy in ER-positive patients. I think it’s certainly worthy of study, although chemotherapy has been in the dominant neoadjuvant position in the United States.

—Hyman Muss, MD

- Review Select Publications

- Review Other Clinical Trials

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