Adjuvant Endocrine Therapy in Hormone Receptor-Positive Postmenopausal Breast Cancer: Evolution of NCCN, ASCO, and St Gallen Recommendations

摘要: Endocrine therapy has a firm role in adjuvant treatment of women with hormone receptor-positive invasive breast cancer. Until recently, tamoxifen was the most commonly used endocrine premenopausal and postmenopausal women. Several randomized clinical trials have studied third-generation selective aromatase inhibitors (AIs) (anastrozole, letrozole, exemestane) as These studies compared an AI alone versus alone; 2 to 3 years followed by switching continuation tamoxifen; or extended after approximately 5 therapy. No statistically significant differences overall survival were observed. A single trial using suggests small, advantage axillary lymph node-positive disease while showing no decrease use AI. The toxicities AIs are generally acceptable, fewer endometrial cancers, gynecologic complaints, thromboembolic events, but more bone fractures arthralgias alone. Three widely disseminated guidelines, National Comprehensive Cancer Network Breast Clinical Practice Guidelines Oncology, American Society Oncology Technology Assessment on Use Aromatase Inhibitors, St Gallen International Expert Consensus Primary Therapy Early Cancer, now incorporate estrogen