A prospective study of aromatase inhibitor therapy initiation and self-reported side effects



The objective of this study was to examine the associations between aromatase inhibitors (AIs) and side effects less frequently reported in the literature, including difficulty concentrating, forgetfulness, hair loss, and numbness in the extremities.


Data were analyzed from a cohort of 146 breast cancer patients initiating AI therapy and followed for 1 year and a cohort of 144 postmenopausal women without a history of cancer followed for 6 months. At baseline (prior to AI therapy for breast cancer patients), and at 3 months, 6 months, and 1 year (for breast cancer patients only), a comprehensive questionnaire was administered that ascertained data on symptoms. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using logistic regression for new onset of symptoms among the breast cancer patients compared to the women without a history of cancer.


Among the breast cancer patients, 34.2% were treated with chemotherapy prior to AI treatment. Over the first 6 months of AI treatment, breast cancer patients had significantly higher odds of reporting new onset of forgetfulness (OR 4.00; 95% CI 1.67, 9.59), difficulty concentrating (OR 2.73; 95% CI 1.29; 5.78), hair loss (OR 4.12; 95% CI 1.86, 9.17), and numbness/tingling in the extremities (OR 2.47; 95% CI 1.09, 5.62) compared to women without a history of cancer. Similar increases in odds were observed for the subgroup of women not treated with chemotherapy versus the comparison group.


AI-related symptoms should be monitored and addressed so that adherence to therapy is maintained.

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This study was funded by Susan G. Komen Foundation (grant number KG 110356). The work described in this manuscript was carried out by the authors as prior employees at Mercy Medical Center, to which the grant was awarded. The views expressed do not necessarily represent the views of the National Institutes of Health or the United States Government.

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Correspondence to Lisa Gallicchio.

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The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Gallicchio, L., Calhoun, C. & Helzlsouer, K. A prospective study of aromatase inhibitor therapy initiation and self-reported side effects. Support Care Cancer 25, 2697–2705 (2017) doi:10.1007/s00520-017-3678-8

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  • Aromatase inhibitors
  • Breast cancer
  • Cognitive dysfunction
  • Hair loss
  • Neuropathy