Safely promoting breast-conserving surgery and preventing early relapses with an aromatase inhibitor

摘要: Neoadjuvant therapy improves patient outcomes substantially by increasing the rate of breast-conserving surgery. Following primary surgery, women with hormone-sensitive early breast cancer remain at risk for loco-regional and systemic recurrence. The most common relapse event, distant metastases, is associated poorest outcomes. As a neoadjuvant therapy, anastrozole, letrozole, exemestane have been investigated in phase 3 studies shown efficacy this setting. All three aromatase inhibitors (AIs) significantly improved initial adjuvant third-generation AIs anastrozole letrozole more effectively reduce recurrence compared tamoxifen following especially first 2 years, when greatest. Tamoxifen, once standard disease-free survival but may be effective reducing than metastases. Initial has also pronounced reduction metastases on course therapy. If are not used upfront, sequential use or provides greater protection against continuing tamoxifen. Side effects estrogen deprivation less serious those easily managed. Various molecular markers under study as surrogates to predict response which turn responsiveness Surgeons treating patients prescribing endocrine should aware all treatment strategies, including hormonal inform their benefits potential side effects. Early long-term-risk AI discussed patients, management AI-associated adverse events.