Adjuvant therapy for breast cancer: Hormonal therapy

Approximately two-thirds of patients diagnosed with early-stage breast cancer have hormone-sensitive disease (estrogen receptor [ER]-positive and/or progesterone receptor [PR]-positive), and as a result, adjuvant endocrine therapy plays a critical role in reducing the risk of recurrence and improving survival. Data generated from clinical trials over the last 30 years has definitively demonstrated the positive impact of adjuvant endocrine therapy, first with the use of tamoxifen and more recently with the use of aromatase inhibitors either as monotherapy or in sequence with tamoxifen. Many issues need to be understood when considering the optimal approach for adjuvant endocrine therapy in an individual patient, both in terms of optimizing risk reduction and maintaining quality of life. The following discussion will summarize the current state of the art in 2013 and also highlight unresolved research issues of clinical importance.