The choice and initiation of tamoxifen or aromatase inhibitor (anastrozole, exemestane or letrozole) will be determined by the Breast Surgeon or Oncologist. Refer to Strategy for the use of Adjuvant Aromatase Inhibitors (AI) and Tamoxifen.  It is recommended that:

  • all patients switching from tamoxifen to an AI should have a DXA scan shortly afterwards
  • blood lipids are checked around 4 to 6 months after switching.

In patients with metastatic breast cancer the use of bisphosphonates may prevent skeletal complications of bone metastases; see Cancer Centre guidance.

ANASTROZOLE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 1mg (specialist use only)

Dosage:

See SMC advice 90/04, 198/05, and NICE guidance TA112.

EXEMESTANE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 25mg (specialist use only)

Dosage:

See SMC advice 210/05, and NICE guidance TA112.

LETROZOLE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 2·5mg (specialist use only)

Dosage:

See SMC advice 152/05, and NICE guidance TA112.

TAMOXIFEN

Important: Therapy notes

Tamoxifen can increase the risk of thromboembolism particularly during and immediately after major surgery or periods of immobility (see SPC). Advise patients of the symptoms of thromboembolism and to report sudden breathlessness and any pain in the calf of one leg.

Important: Formulation and dosage details

Formulation:

Tablets 20mg (specialist use only)

Important: Formulation and dosage details

Formulation:

Oral solution 10mg/5mL (specialist use only)

Editorial Information

Document Id: F296