From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Letrozole, an aromatase inhibitor, typically does not need to be withheld prior to surgery, as it does not significantly affect bleeding, wound healing, or anesthesia interactions, and maintaining consistent letrozole levels is often beneficial for ongoing cancer treatment. The medication works by reducing estrogen production by blocking the aromatase enzyme, which is particularly important for postmenopausal women with hormone receptor-positive breast cancer.
Key Considerations
- Letrozole can be safely delivered shortly after surgery and concomitantly with radiotherapy, as shown in a study published in The Lancet. Oncology 1.
- The optimal duration of neoadjuvant letrozole to permit breast-conserving surgery is around 7.5 months, as suggested by a multicenter, prospective, longitudinal phase IV study published in Breast cancer research and treatment 2.
- Letrozole has a good short-term tolerability profile, with most adverse events being mild to moderate, as reported in a review of its use in postmenopausal women with advanced breast cancer published in Drugs 3.
Clinical Implications
- Patients can generally continue taking letrozole throughout the perioperative period without interruption, unless individual circumstances dictate otherwise.
- The decision to temporarily discontinue letrozole should be made by the healthcare team based on the specific surgical procedure and the patient's overall treatment plan.
- Letrozole's ability to reduce tumor size and improve the likelihood of breast-conserving surgery makes it a valuable treatment option for patients with hormone receptor-positive breast cancer, as demonstrated by a study published in Breast cancer research and treatment 4.
Ongoing Treatment
- Maintaining consistent letrozole levels is crucial for ongoing cancer treatment, and any decision to withhold or discontinue the medication should be carefully considered in the context of the patient's overall treatment plan.
- Patients should always discuss their complete medication regimen with their surgeon and oncologist before surgery to ensure the best possible outcomes, as supported by the findings of a pilot study published in Breast cancer (Tokyo, Japan) 5.