Inadvertent use of aromatase inhibitors in patients with breast cancer with residual ovarian function: Cases and lessons

Aromatase inhibitors (Als) are important adjunctive therapy for postmenopausal women with hormone receptor-positive, early-stage breast cancer. At the present time, Als have no role for the management of breast cancer in premenopausal women. We report on several cases of the inadvertent use of Al therapy among women with residual ovarian function. A common experience in these cases was the onset of chernotherapy-related amenorrhea before initiation of A[ therapy, which confounded assessment of true menopausal status. We believe clinicians should be aware of the potential ovarian reserve among women with treatment-related amenorrhea so as to avoid use of Al therapy in patients in whom there is uncertainty about menopausal status.