What is it about?

Letrozole, Anastrozole and Exemestane medications are given to women with Oestrogen fed breast cancers after surgery, to reduce the risk of the cancer returning. They cause many painful side effects of the joints and bones, which make nearly 40% of women to stop taking them. This is the story of five women, who had swelling of their arms and hands, thought to be lymphoedema, because of their surgery, which was caused by their medication, Letrozole. They were all slim, which made the side effects worse. The swelling reversed when their medication was stopped.

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Why is it important?

This side effect has not been documented before. The symptoms can be reversed if the medications are reviewed by the consultant. Many slim women may be suffering unnecessarily. Lymphoedema therapists are probably not aware of this side effect.


I work alone in a small practice. Over 3 months, 5 slim women were referred to me with swellings of their arms which did not respond to usual therapies. In my quest to help them, I looked at every aspect of the treatment I was giving and the shared drug regimes and other symptoms the women shared. After a process of elimination, the only shared factor was Letrozole. I sent them all back for a risk-benefit analysis of Letrozole with their consultants.

Clare Anvar

Read the Original

This page is a summary of: The role of aromatase inhibitors in slim women with breast cancer-related lymphoedema: a reflective case series, British Journal of Community Nursing, October 2023, Mark Allen Group,
DOI: 10.12968/bjcn.2023.28.sup10.s14.
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