Adjuvant Endocrine Therapy for Women with Hormone Receptor–Positive Breast Cancer: Update from the American Society of Clinical Oncology | NEJM Clinician
New guidelines emphasize use of aromatase inhibitors, whether alone or sequentially with tamoxifen.
Based on findings published since 2004, the American Society of Clinical Oncology (ASCO) has updated its previous guidelines (JW Womens Health Apr 6 2005), focusing on optimal adjuvant endocrine strategies involving tamoxifen, aromatase inhibitors (AIs), or both in sequence. Highlights of the new guidelines are as follows:
To lengthen disease-free survival and lower risk for recurrence (i.e., locoregional or distant recurrence or contralateral breast cancer), postmenopausal women with hormone receptor–positive breast cancer should consider an AI, either as primary adjuvant therapy for ≤5 years or sequentially after 2 to 3 years of tamoxifen to yield a total of 5 years of adjuvant endocrine therapy. Women who discontinue initial AI therapy be…