Adjuvant Endocrine Therapy for Breast Cancer

  • Several trials showed that extended adjuvant endocrine therapy beyond 5 years provides additional benefit in terms of reduction of disease recurrence
  • According to ASCO guidelines, all patients with node-positive disease should be offered 10 years of adjuvant ET
  • Guidelines from the European Society for Medical Oncology (ESMO) also note that 10 years of treatment is advantageous. Moreover, women with node-negative breast cancer may be offered extended adjuvant endocrine therapy for up to 10 years, on the basis of considerations of recurrence risk using established prognostic factors
  • Conversely, women with low-risk, node-negative tumors should notroutinely be offered extended therapy because the absolute reduction of recurrence risk is likely to be small in this category of patients
  • The ESMO notes that extended therapy should not be offered to those with a very low risk of relapse
  • Similarly, 5 years of ovarian function suppression with either tamoxifen or an aromatase inhibitor provides an additional benefit for this patient population. However, there is no evidence that continuing ovarian function suppression alone beyond 5 years provides additional benefit

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