Optimizing adjuvant endocrine therapy for early ER+ breast cancer: An update for surgeons.

Abstract:

INTRODUCTION:The optimal duration of adjuvant endocrine therapy in early ER + breast cancer has been controversial. This article aims to provide an overview of the evidence. METHODS:A search of the literature was conducted via MEDLINE using appropriate keywords. Eligible studies were screened and relevant articles were selected for this report. RESULTS:Studies investigating the role of extended adjuvant tamoxifen beyond 5 years have revealed mixed results depending on the proportion of node positivity. In postmenopausal women, aromatase inhibitors (AIs) for 5 years are superior to tamoxifen. Extending the use of AIs beyond 5 years seem to reduce the risk of relapse in postmenopausal women with node positive disease. The addition of bisphosphonates to counteract AI-related osteopenia may further improve overall and disease-free survival. Women younger than 40 years seem to benefit from ovarian suppression combined with tamoxifen or exemestane. CONCLUSIONS:An individualised approach is required for every patient. The adverse effects of endocrine therapy should be weighed against the potential benefits of extended therapy to better inform decision-making.

journal_name

Am J Surg

authors

Wazir U,Mokbel L,Wazir A,Mokbel K

doi

10.1016/j.amjsurg.2018.07.052

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

152-155

issue

1

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(18)30269-1

journal_volume

217

pub_type

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