Aromatase inhibitor associated arthralgia: the importance of oncology provider-patient communication about side effects and potential management through physical activity



Breast cancer survivors on aromatase inhibitors (AI) often experience side effects of joint pain, stiffness, or achiness (arthralgia). This study presents findings from a qualitative study of survivors on an AI regarding their knowledge of potential joint pain side effects and how both AI side effects and their management through moderate physical activity could be discussed during routine visits with their oncology provider.


Qualitative data from semi-structured interviews were content analyzed for emergent themes. Descriptive statistics summarize sample characteristics.


Our sample included 36 survivors, mean age of 67 (range 46–87); 86 % Caucasian and 70 % had education beyond high school. AI experience are as follows: 64 % anastrozole/Arimidex, 48 % letrozole/Femara, and 31 % exemestane/Aromasin. Participants expressed interest in having more information about potential joint pain side effects when the AI was prescribed so they could understand their joint symptoms when they appeared or intensified. They were relieved to learn that their joint symptoms were not unusual or “in their head.” Participants would have been especially motivated to try walking as a way to manage their joint pain if physical activity had been recommended by their oncologist.


Breast cancer survivors who are prescribed an AI as part of their adjuvant treatment want ongoing communication with their oncology provider about the potential for joint pain side effects and how these symptoms may be managed through regular physical activity. The prescription of an AI presents a “teachable moment” for oncologists to recommend and encourage their patients to engage in regular physical activity.

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Author information

Correspondence to Kirsten A. Nyrop.

Ethics declarations

The study protocol was approved by the Lineberger Comprehensive Cancer Center Protocol Review Committee and the Institutional Review Board of the University of North Carolina at Chapel Hill.

Conflict of interest

This research is supported by the National Cancer Institute of the National Institutes of Health under award number R21CA169492 and a pilot grant from the UNC Institute on Aging. The authors do not have a financial relationship with either organization. All authors have participated in writing, reviewing, and/or editing the manuscript. The principal investigator has full control of all primary data and agrees to allow the journal of Supportive Care in Cancer to review our data if requested. We thank the Arthritis Foundation, UNC Thurston Arthritis Research Center, and the North Carolina Cancer Hospital oncology physicians and clinical staff for their interest and support throughout the study, as well as the breast cancer survivors who participated in this study.

Additional information

Anne Wilson and Arielle Schechter are patient advisors to the study.

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Nyrop, K.A., Callahan, L.F., Rini, C. et al. Aromatase inhibitor associated arthralgia: the importance of oncology provider-patient communication about side effects and potential management through physical activity. Support Care Cancer 24, 2643–2650 (2016).

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  • Physical activity
  • Aromatase inhibitor
  • Pain
  • Adaptation