Metastatic Breast Cancer

In breast cancer, metastases can present at any time and in locations that are not common. Moreover, in addition to the usual common locations, such as the brain, lung, liver, and other breast. Women may experience metastatis to their skin or head and neck region. These present as uclerated and eroded rashes or lymphadenopathy usually.

Post-Menopausal Females and Aromatase Inhibitors

In post-menopausal females, aromatase inhibitor drugs work effectively. This is because aromatase inhibitors act by reducing the conversion of peripheral androgen to estrogen. This is the process which feeds estrogen positive tumours. This minor block in estrogen stimulation is enough to have a positive effect on tumour growth. In pre-menopausal women, normal functioning ovaries produce much more estrogen than peripheral production of estrogen which is seen in post-menopausal females. An aromatase inhibitor therefore cannot do much in pre-menopausal females, unless these patients have removal of their ovaries or have radiation ablation of both ovaries to make them menopausal. An aromatase inhibitor may actually be worse in pre-menopausal women due to the fact that a minor reduction in peripheral estrogen production may actually hyperstimulate the ovaries to produce more estrogen.

Aromatase Inhibitors versus Tamoxifen

In conclusion, however, in post-menopausal women, aromatase inhibitors are first choice and much better than tamoxifen.