letrozole and low white blood cells

I am 67yrs old and have been on Letrozole for about 18 months following a mastectomy for lobular breast cancer in May 2024. A recent blood test has shown my white blood cells are low and now outside the therapeutic range. They have gone from 5.3 pre mastectomy to 4.5 last year and 3.6 now. I am having another blood test in a month's time before any decisions are taken.

Assuming it is the Letrozole behind this, what are my options? I was given the all clear at the time so wondered about the risks of stopping it or moving to an alternative. 

I have osteoporosis so have also been worried about the bone density effects of letrozole, but have upped my weight bearing exercises in this regard. 

  • Hello MaryGibbs and thanks for your post,

    There are other alternative endocrine therapies that the doctors may consider using if your white blood count continues to drop. Do wait to see what happens in a month.

    The doctors may want to continue to monitor you after a month, particularly if it does not drop much further and you are not experiencing any other side effects.

    If it continues to drop the doctors may consider changing you to one of the other aromatase inhibitors. Everyone reacts to drugs in different ways and you may find that one of the others don't effect your white blood cells in the same way.

    You have posted in 'ask the nurses' but if you post on a different thread or start your own in a different category on the forum you may find that you hear from other women who have had a similar issue with their blood count.

    If you would like to talk any of this through with one of the helpline nurses then you are welcome to give us a ring.

    The number to call is Freephone 0808 800 4040 and the lines are open Monday to Friday 9 am to 5 pm.

    Al the best,

    Catherine