Aromatase-Inhibitor–Induced Joint Complaints: An Underappreciated Problem?

Adjuvant aromatase inhibitors (AIs) are now the standard of care for postmenopausal women with hormone-receptor–positive early-stage breast cancer. Which is the optimal AI and how it should be used remain open questions; however, in the large clinical trials in which adjuvant AIs (either in lieu of tamoxifen or sequentially after tamoxifen) have been investigated, researchers have noted improvements in patient outcomes, largely in disease-free survival (DFS). In all the trials that have included AIs, musculoskeletal (MS) and joint complaints were more common in patients who received an AI than in those who received tamoxifen alone. For example, in the ATAC trial (Journal Watch Women’s Health Sep 24 2002), in which 5 years of tamoxifen was c…