1 Guidance

1 Guidance

This guidance applies to the use of the aromatase inhibitors anastrozole, exemestane and letrozole, within the marketing authorisations for each drug at the time of this appraisal, for the treatment of early oestrogen-receptor-positive breast cancer; that is:

  • anastrozole for primary adjuvant therapy

  • exemestane for adjuvant therapy following 2–3 years of adjuvant tamoxifen therapy

  • letrozole for primary adjuvant therapy and extended adjuvant therapy following standard tamoxifen therapy.

1.1 The aromatase inhibitors anastrozole, exemestane and letrozole, within their licensed indications, are recommended as options for the adjuvant treatment of early oestrogen-receptor-positive invasive breast cancer in postmenopausal women.

1.2 The choice of treatment should be made after discussion between the responsible clinician and the woman about the risks and benefits of each option. Factors to consider when making the choice include whether the woman has received tamoxifen before, the licensed indications and side-effect profiles of the individual drugs and, in particular, the assessed risk of recurrence.