LETROZOLE ROLE IN BREAST CANCER AND INFERTILITY: A REVIEW OF LITERATURE.
Keywords:
Key words: postmenopausal women, Letrozole, Aromatase inhibitors, controlled ovarian hyperstimulation, Clomiphene, Tamoxifen.Abstract
Abstract
Letrozole is being considered as potential prophylactic agent for breast cancer after
discontinuation of 5-year tamoxifen therapy for steroid HR-positive breast cancer in
postmenopausal women with breast cancer letrozole effect along with RT in aromatase
expressing breast tumour cell showed efficacy as oral administration along with favourable
toxicities when taken orally. Letrozole improves disease free survival in metastatic breast cancer
Therapy with zoledonic acid is required as long-term use of aromatase inhibitior results in bone loss
Letrozole is potent competitive aromatase inhibitor, a nonsteroidal Benzhydroltriazole derivative,
highly selective. Women who had taken tamoxifen for 5 years after discontinuation have taken
letrozole and chances of recurrence were less depending upon tumour characteristics. Therapy with
letrozole lasts usually 3-4 months and has been extended up to 12 months. Aromatase inhibitors
are now a days used worldwide as adjuvant therapy, particularly letrozole significantly improves
disease free survival and time to distant recurrence In contrast to tamoxifen, letrozole cause
decrease in circulating estrogen levels. Letrozole is better considered for disease free survival in
postmenopausal women for preventing metastatic breast cancer in contrast to tamoxifen. Letrozole
for its ovulatory effect is proved to be better with many respects as compared to clomiphene citrate.
Though with some respects and in some research patterns clomiphene citrate came out to be a better
ovulation stimulator but still letrozole has fewer side effects as compared to clomiphene citrate and
more thickening of endometrial layer which is certainly a supportive factor for clinical pregnancy.
Furthermore letrozole when used with combination of FSH and GnRH for ovulation stimulation,
it decreases the dose required for fertility when either of both (FSH, GnRH) used alone. In women
undergoing IUI and IVF it also plays a supportive role by improving the endocrine environment of the
women.
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