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Dear All Could someone point me in the direction of any publication that supports "Arimidex may incompletely block E2 production" Michael Freemantle|Scientist|Biochemistry - Endocrinology Sullivan Nicolaides Pathology P + 61 7 3377 8663| E [log in to unmask] <mailto:[log in to unmask]> ________________________________ From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Taylor, Andrew Sent: Wednesday, 19 January 2011 02:16 To: [log in to unmask] Subject: breast cancer treatment Dear all The problem of providing an opinion on whether a patient with breast cancer should be on tamoxifen or aromatase inhibitor occurs quite frequently, and has been covered a couple of times in the UKNEQAS interpretive comments scheme: see " Identifying menopause in breast cancer patients: considerations and implications, Clemons M & Simmons C, Breast Cancer Res Treat 104, 115-120 (2007)". I have summarised a couple of recent cases below and my opinion. I would welcome any comments. Thanks A Case 1 51 yrs old, amenorrhoea 2y, LH 11.5 IU/l, FSH 21.4 IU/l and Oestradiol <75 pmol/l. On Tamoxifen. Opinion: Probably post-menopausal. Suggest change to arimidex and recheck FSH (Tamoxifen may suppress FSH by c 30-50% in some post menopausal women - Kostoglou-Athanassiou et al, Horm Res 47, 116-120 (1997), Lonning et al, J Steroid Biochem Mol Biol 51, 491-496 (1995)) Case 2 52yrs old, amenorrhoea <1y, LH 29.3 IU/l, FSH 37.4 IU/l and Oestradiol 254 pmol/l. On arimidex Opinion: Probably premenopausal. Suggest change back to tamoxifen or consider ovarian ablation (Arimidex may incompletely block E2 production, FSH rise in response, sufficiently to drive E2 production back into premenopausal range) ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/