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Aromatase inhibitors are medications that block the production of estrogen by fat and adrenal cells in postmenopausal women. Common aromatase inhibitors include anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin).
Unlike SERMs, aromatase inhibitors do not improve bone density. In fact, they may actually accelerate bone loss in postmenopausal women. However, aromatase inhibitors appear to cause fewer side effects and do not appear to have the risk of blood clots or endometrial cancer as seen with tamoxifen.
No trials have been conducted on the use of aromatase inhibitors for the prevention of breast cancer in women with a BRCA mutation.