15-Year SOFT & TEXT Results: Practice-Changing Evidence for Premenopausal HR+/HER2− Early Breast Cancer

Rodrigo Arrangoiz MS, MD, FACS, FSSO

The final 15-year analysis of the landmark SOFT and TEXT phase III trials provides the longest follow-up to date for endocrine therapy in premenopausal women with hormone receptor-positive early breast cancer.

These data reinforce that treatment intensity should be tailored according to recurrence risk. 

Key takeaways:

• Ovarian function suppression (OFS) significantly reduces breast cancer recurrence compared with tamoxifen alone.

• Exemestane + OFS provides the greatest reduction in recurrence and distant metastases, particularly in HER2-negative disease.

• The largest overall survival benefit was observed in high-risk patients, especially:

  • Women < 35 years old
  • High-grade tumors
  • Patients requiring adjuvant chemotherapy

• For lower-risk patients who did not require chemotherapy, long-term survival remained excellent regardless of the endocrine regimen, emphasizing the importance of individualized treatment decisions.

Clinical Message

This landmark study confirms that not every premenopausal patient requires the same endocrine therapy. Careful risk stratification allows us to maximize oncologic outcomes while minimizing unnecessary toxicity. Personalized, multidisciplinary breast cancer care remains essential for achieving the best long-term results. 

Rodrigo Arrangoiz, MS, MD, FACS, FSSO
Breast Surgeon | Head & Neck Surgical Oncologist | Thyroid & Parathyroid Surgeon
Assistant Professor of Surgery, New York Medical College School of Medicine
Division of Surgical Oncology
Braman Comprehensive Cancer Center
Mount Sinai Medical Center – Miami, Florida

#BreastCancer #BreastSurgery #SurgicalOncology #BramanCancerCenter #MountSinaiMiami #HormonePositiveBreastCancer #PremenopausalBreastCancer #SOFTTrial #TEXTTrial #EvidenceBasedMedicine #CancerCare

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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