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The benefits of incorporating an aromatase inhibitor (AI) into adjuvant therapy for estrogen-receptor (ER)–positive early-stage breast cancer are no longer questioned, but the optimal use of an AI in this setting remains to be defined. In a manufacturer-funded, randomized, open-label German trial, investigators enrolled postmenopausal women with invasive ER-positive breast cancer (axillary-node negative or <10 positive nodes; no known distant metastases) who had received 2 years of tamoxifen (20 or 30 mg per day) with no disease recurrence. Participants (mean age, 61) were randomized to switch to the AI anastrozole (1 mg per day; n=489) or to continue tamoxifen for 3 years (n=490).
Women who received anastrozole experienced a 39% reduction i…