Paper II
2019 July (Supplementary) (2010 Scheme)

Question

Letrozole in early breast cancer

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Answer

Letrozole is an aromatase inhibitor. In postmenopausal women, oestrogen is synthesized peripherally (in adipose tissue, etc.) by the enzyme aromatase, which converts androgens to oestrogens — this becomes the major source of oestrogen after ovarian function ceases. Many breast cancers are hormone-receptor-positive and dependent on oestrogen for growth. By inhibiting aromatase, letrozole blocks this peripheral oestrogen synthesis, depriving the tumour of the oestrogen needed for growth, making it effective adjuvant therapy for hormone-receptor-positive early breast cancer in postmenopausal women.

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