Breast cancer is a significant health issue affecting many women worldwide. In New Zealand, it's the most common cancer and the second leading cause of death for women. The impact of breast cancer varies among different ethnic groups. Māori and Pacific women are more likely to get breast cancer than New Zealand European women. However, they are less often diagnosed through regular breast screening. This means their cancer is often found at a later stage. Sadly, Māori and Pacific women are almost twice as likely to die from breast cancer compared to women of other ethnicities.

Aromatase inhibitors are drugs that have been shown to be very effective in treating a type of breast cancer called oestrogen-positive breast cancer. Studies have found that these drugs help patients live longer without the cancer coming back and also improve overall survival rates for both early-stage and advanced breast cancers.

Aromatase inhibitors (such as anastrozole, letrozole, and exemestane) are mainly used by women who have gone through menopause and have oestrogen-positive breast cancer. They're usually given after surgery and other treatments like radiotherapy or chemotherapy. These drugs work by stopping the body from making oestrogen, which can help slow down or stop the growth of tumours that are sensitive to hormones.

For women who haven't gone through menopause, using aromatase inhibitors is trickier. Here's why:

1. These women's ovaries still make a lot of oestrogen, which can fuel hormone-sensitive breast tumours.

2. Aromatase inhibitors don't stop the ovaries from making oestrogen.

3. To use these drugs in women before menopause, doctors need to stop the ovaries from making hormones. They do this with a medicine called Zoladex.

4. Both aromatase inhibitors and Zoladex can cause side effects.

5. Because of these side effects, doctors only use this combination for women with a high risk of cancer coming back.

While aromatase inhibitors are very effective in treating oestrogen-positive breast cancer, they can have some side effects and risks. These include:

• Bone health problems: These drugs can weaken bones, increasing the risk of osteoporosis and fractures. Regular bone check-ups and taking calcium and vitamin D supplements may be necessary.

• Heart and blood vessel issues: Some studies have found that these drugs might increase the risk of heart attacks and strokes. People with existing heart problems may need extra care and monitoring.

• Menopause symptoms: By reducing estrogen levels, these drugs can cause or worsen symptoms like hot flashes, night sweats, and vaginal dryness. These side effects can greatly affect a person's quality of life and may need additional treatment.

• Memory and thinking changes: Some research suggests these drugs might affect memory and concentration. More studies are being done to understand the long-term effects on brain function.

• Liver problems: In rare cases, these drugs can harm the liver. This might require changing the dose or stopping the medication.

In summary, aromatase inhibitors have greatly improved the treatment of oestrogen-positive breast cancer. However, it's important for doctors and patients to be aware of the potential risks and side effects of these medications and monitor them closely.