Anastrozole, Exemestane or Letrozole will work well - nolva and clomid won't.
Aromatase inhibitors: cellular and molecular effects.
Miller WR, Anderson TJ, White S, Larionov A, Murray J, Evans D, Krause A, Dixon JM.
Breast Unit, Western General Hospital, Edinburgh, Scotland, UK. w.r.miller@ed.ac.uk
Marked cellular and molecular changes may occur in breast cancers following treatment of postmenopausal breast cancer patients with aromatase inhibitors. Neoadjuvant protocols, in which treatment is given with the primary tumour still within the breast, are particularly illuminating. In Edinburgh, we have shown that 3 months treatment with either anastrozole, exemestane or letrozole produces pathological responses in the majority of oestrogen receptor (ER)-rich tumours (39/59) as manifested by reduced cellularity/increased fibrosis. Changes in histological grading may also take place, most notably a reduction in mitotic figures. This probably reflects an influence on proliferation as most tumours (82%) show a marked decrease in the proliferation marker, Ki67. These effects are generally more dramatic than seen with tamoxifen given in the same setting. Differences between aromatase inhibitors and tamoxifen are also apparent in changes in steroid hormone expression. Thus, immuno-staining for progesterone receptor (PgR) is reduced in almost all cases by aromatase inhibitors, becoming undetectable in many. This contrasts with effects of tamoxifen in which the most common change on PgR is to increase expression. Changes in proliferation occur rapidly following the onset of exposure to aromatase inhibitors. Thus, neoadjuvant studies with letrozole in which tumour was sampled before and after 14 days and 3 months treatment show that decreased expression of Ki67 occur at 14 days and, in many cases, the effect is greater at 14 days than 3 months. These early changes precede evidence of clinical response but do not predict for it. However, this study design has allowed RNA analysis of sequential biopsies taken during the neoadjuvant therapy. Based on clustering techniques, it has been possible to subdivide tumours into groups showing distinct patterns of molecular changes. These changes in tumour gene expression may allow definition of tumour cohorts with differing sensitivity to aromatase inhibitors and permit early recognition of response and resistance.
PMID: 16002280 [PubMed - indexed for MEDLINE]
Also oxymetholone may also work to combat the potential gyno - if that is your main concern ( and perhaps winny) :
Inhibition of progestational activity for fertility regulation.
Chatterton RT.
PIP: This review examines a number of areas of postconceptive fertility regulation, focusing on promising new antiprogestational agents. Pregnancy is dependent upon the availability of progesterone for the uterus and its withdrawal results in the breakdown of the secretory endometrium. Its availability can be interferred with at several levels and the new methods which allow for progesterone inhibition must be tested for possible defeminizing properties or for serious side effects. In the evaluation of contragestational agents, several areas must be taken into consideration--assessment of biological activities, dose requirements and mode of action, duration of effects, route of administration, and drug tolerance and side effects. The failure to maintain progesterone in the blood at levels required for pregnancy maintenance may be due to a decrease in progesterone secretion by the ovary or to an increased rate of metabolism and excretion of circulating progesterone. The various substances discussed do either 1 or the other; however even when a compound is known to result in a decrease in the rate of progesterone secretion, the process by which it does this may not be known. Prostaglandins seem to affect myometrial contraction, luteinizing hormone releasing hormones can inhibit steroid production or interfere with LH binding to its receptor, and immunization against hCG is a successful immunological approach to conception. Lithospermic acid is another substance which interferes with gonadotropin support of the ovary and has good potential. Other compounds that interfere with progesterone secretion act to inhibit steroidogenesis in the ovary and placenta; such substances include aminoglutethimide, oxymetholone, trilostane, azastene, and danazol. Another progesterone-suppression method would remove a sufficient amount of progesterone from the body to cause endometrium involution and promote contractility of the myometrium. Progesterone antagonists include ORF 9361, R3434, Anordrin, ORF 3858, and other estrogens, triazole compounds, ORF 5513, trichosanthin, and zoapatanol.
