Which treatment is recommended for postmenopausal women concerning estrogen blocking?

In the management of postmenopausal women with estrogen receptor-positive breast cancer, the primary treatment recommendation typically involves the use of aromatase inhibitors. Aromatase inhibitors work by blocking the aromatase enzyme, which is responsible for converting androgens to estrogens in peripheral tissues, effectively lowering estrogen levels in the body. This decrease in estrogen can help slow or stop the growth of estrogen-dependent tumors.

Aromatase inhibitors are especially indicated for postmenopausal women because their main source of estrogen is through the conversion of androgens, and their ovaries no longer produce significant amounts of estrogen. This makes aromatase inhibitors a logical first-line choice for hormone receptor-positive breast cancer in this patient population.

Tamoxifen, while effective as an estrogen receptor modulator, is primarily used in premenopausal women or in situations where adjuvant therapy is warranted in postmenopausal women if aromatase inhibitors are not suitable. The response to treatment can vary based on individual patient factors, but the use of tamoxifen alone is not typically the first line in postmenopausal cases where aromatase inhibitors are recommended.

The combination of tamoxifen and aromatase inhibitors, although studied, is less