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NCCN Guidelines for Patients


Breast Cancer - Early-Stage


, Version 1.2016


Endocrine therapy

What to expect

also stops the ovaries from making estrogen and

progesterone, but isn’t used often.

Side effects

For many women, endocrine therapy causes

symptoms of menopause. Menopausal symptoms

include hot flashes, vaginal discharge or dryness,

sleep problems, weight gain, hair thinning, fatigue,

and changes in mood. Which symptoms you will have

may differ from other women.

Tamoxifen also has two rare but important side

effects. They are cancer of the uterus and blood clots.

For most women with breast cancer, the benefits of

taking tamoxifen far outweigh the dangers.

Aromatase inhibitors don’t cause cancer and very

rarely cause blood clots. However, they can weaken

your bones (osteoporosis) and cause bone fractures.

Checking your bone health with regular bone mineral

density tests can show bone weakness before

fractures occur. Your doctor can order medicine

to strengthen your bones if necessary. Aromatase

inhibitors can also cause joint pain in some women.

Not all the side effects of endocrine therapy are listed

here. Please ask your treatment team for a list of all

common and rare side effects. If a side effect bothers

you, tell your treatment team. There may be ways to

help you feel better.

Figure 6.1 Antiestrogens

Antiestrogens are drugs that stop the effect of estrogen on cancer cell growth. Tamoxifen is an

antiestrogen that is commonly used for stages I and II breast cancer. It blocks estrogen from

attaching to its receptor and starting cell growth.

Tamoxifen blocks estrogen

so cell growth isn't triggered

Estrogen binds to receptors

and triggers cell growth