What Is Anastrozole? Understanding Its Impact On Breast Cancer Reduction
Anastrozole is a drug that halves a woman's risk of breast cancer and continues to work long after she stops taking it, according to researchers.
A drug that halves a woman’s risk of breast cancer continues to work long after they stop taking it, say researchers. Anastrozole blocks the production of the hormone oestrogen, which fuels the growth of many breast cancers. It is already available in the UK, but researchers at the Queen Mary University of London said only a tenth of eligible women were receiving it. Also, Cancer Research UK said the findings were reassuring. For the purpose of this article, we will explore the answers to the question: what is Anastrozole?
What Is Anastrozole, and who can take it?
Anastrozole can be given only after menopause because it cannot suppress oestrogen in younger women. Doctors already use it as a treatment once they diagnose breast cancer. But now trials are focusing on preventing cancers from emerging in the first place.
Previous research has shown anastrozole halves the risk of breast cancer during the five years women took the drug. But now, trials on 3,864 women show those taking it had 49% fewer breast cancers, even seven years after stopping treatment.
In other words – the benefit lasts.
The findings have been published in the Lancet and presented at the San Antonio Breast Cancer Symposium in Texas.
“Breast cancer is the commonest cancer in women and continuing to rise very rapidly,” Prof Jack Cuzick, the director of the Wolfson Institute of Preventive Medicine at Queen Mary University of London, told the BBC.
He added: “We now have an agent that looks really effective, with minimal side-effects.”
Isn’t this already available?
Doctors have encouraged post-menopausal women at high risk of developing breast cancer; due to family history and other risk factors, to take the drug since 2017.
“Uptake has really been quite low,” said Prof Cuzick. “Currently it's about 10% of these women and we think it should be substantially higher.”
One issue is that doctors are concerned about whether there is a long-term benefit. Another was around side-effects such as stiff joints, hot flushes, and vaginal dryness.
However, the study showed 75% of women given anastrozole were able to stick with the medication, compared with 77% who received a daily sugar pill. The academics say this suggests that the side-effects are not severe enough to stop women from taking the drug.
How does the drug stop cancer?
Cancers are a corrupted version of healthy tissue.
However, a healthy cell does not become cancerous overnight. Instead, it goes through multiple mutations that gradually morph it from healthy to cancerous.
Anastrozole seems to be able to kill some cells that have begun the journey to becoming cancer.
“You’re setting the clock back 20 years and you have to start from scratch to develop cancer, which might take quite a long time,” Prof Cuzick told the BBC.
Will this eliminate the need for mastectomies?
Taking drugs to prevent breast cancer simply means that mastectomies are not the only preventive treatment anymore. But, some women are at such high risk of developing breast cancer that the danger would be too higher even with medication. They may decide a mastectomy is still the best option.
In the future, we hope that research will be able to predict who is most likely to benefit from the drugs or have the least side effects; which should make such decisions easier.
Are there other drugs?
Another drug that interferes with the hormone oestrogen – tamoxifen – also works to lower the risk of breast cancer. There was a 49% reduction in breast cancer with anastrozole after 12 years (five on treatment and seven years off). The equivalent figure for tamoxifen is 28%.
Dr Ivana Sestak, from Queen Mary, said: “The findings mean that for every 29 women taking anastrozole for five years, one case of breast cancer will be prevented during a 12-year period.
“Around 49 women would need to take tamoxifen for five years to prevent one breast cancer case during the same period.”
However, tamoxifen is effective in women before menopause. Anastrozole is also less expensive than tamoxifen.
What are experts saying?
Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: “These major findings could be really important in helping postmenopausal women at high risk of breast cancer to decide whether anastrozole is the right option for them.
“It is worrying to hear that it may not be being offered to all that could benefit; we need to understand the extent of this potential issue.
“It’s essential that we raise awareness of this option among doctors and patients.”
Prof Charles Swanton, Cancer Research UK’s chief clinician, said: “Up until now we only knew that tamoxifen has long-lasting benefits. So it’s reassuring that this study looking specifically at anastrozole, which has fewer long-term side-effects; gives better protection to women years after they stopped taking the drug.
“Doctors may still decide that tamoxifen is more appropriate for some women, but it’s great that there are options.”