Challenges and Emerging Strategies for Aromatase Inhibitors in Postmenopausal Breast Cancer Treatment

Breast cancer is the most prevalent solid malignant tumor worldwide, affecting 2.26 million women, with approximately 685,000 deaths from the disease, as estimated on an annual basis by the World Health Organization. About 60-80% of invasive breast cancer in postmenopausal women are estrogen or hormone-receptor-positive breast tumors. Endocrine therapy is a cornerstone for treating hormone receptor-positive breast cancer and includes selective estrogen receptor modulators like Tamoxifen and aromatase inhibitors. Besides the therapeutic effects of hormonal therapy, challenges such as osteoporosis induced by aromatase inhibitors, drug resistance, and recurrence complicate the management of breast cancer. Consequently, there is a significant demand for practical approaches to overcome resistance to endocrine therapy and prevent breast cancer metastasis. This article focuses on therapy for estrogen-positive breast cancer and its adverse impact on patient quality of life. It also examines strategies to reduce side effects by combining natural sources with nanocarriers to enhance therapeutic effects and minimize side effects. It also reviews ongoing research aimed at improving outcomes for patients with hormone-positive breast cancer.