Commentary (Harvey): Nonsteroidal and Steroidal Aromatase Inhibitors in Breast Cancer

Hormone-dependent disease is an important and prevalent subtype of breast cancer. It is recognized by the presence of a functional estrogen-receptor apparatus, an indolent clinical course, a greater frequency in older women, and clinical responses to the sequential use of hormonal therapies. Antiestrogens, primarily tamoxifen (Nolvadex), have been the mainstay of hormonal therapy for metastatic disease, preinvasive disease, and as adjuvant treatment, and more recently, as chemoprevention. However, the aromatase inhibitors now provide an additional therapeutic approach for patients who remain candidates for hormonal therapy with disease progression in the face of antiestrogen therapy. The article by Hamilton and Volm presents a timely and succinct review of the biology of aromatase and the current status of aromatase inhibitors as treatment for breast cancer.