Adjuvant Endocrine Therapy
Premenopausal patients with ER-positive, node-positive tumors who continue menstruation after chemotherapy should be offered (in addition to other options) ovarian suppression or ablation with an aromatase inhibitor.
Postmenopausal patients with ER-positive tumors without osteoporosis should generally be started on an aromatase inhibitor.
Postmenopausal patients who have never received an aromatase inhibitor (AI) and who are between five and 10 years from diagnosis of an ER-positive tumor should generally be offered an AI.
In select patients, adjuvant aromatase inhibitors should be continued beyond five years of treatment.
PR status should not currently be used to select adjuvant endocrine therapy.
HER2 status should not currently be used to select adjuvant endocrine therapy.
Over the first two years after diagnosis, both patients with HER2-positive, ER-positive and those with HER2-negative, ER-positive tumors experience clinically significantly fewer relapses when treated with an aromatase inhibitor compared to tamoxifen.
Over the first five years after diagnosis, both patients with HER2-positive, ER-positive and those with HER2-negative, ER-positive tumors experience clinically significantly fewer relapses with five years of an aromatase inhibitor (AI) than with five years of tamoxifen or two to three years of tamoxifen followed by an AI.
How would you generally compare the
efficacy
of an aromatase inhibitor (AI) up front
versus
tamoxifen for two to three years followed by an AI for a woman in average health with a 1.2-cm, Grade II tumor, ER 90%, PR 60% and three positive nodes?
How would you generally compare the
efficacy
of an aromatase inhibitor (AI) up front
versus
tamoxifen for two to three years followed by an AI for a woman in average health with a 1.2-cm, Grade II tumor, ER 90%, PR 60% and three positive nodes?
How would you generally compare the
safety
and
tolerability
of an aromatase inhibitor (AI) up front
versus
tamoxifen for two to three years followed by an AI for a woman in average health with a 1.2-cm, Grade II tumor, ER 90%, PR 60% and three positive nodes?
How would you generally compare the
overall
profile
of an aromatase inhibitor (AI) up front
versus
tamoxifen for two to three years followed by an AI for a woman in average health with a 1.2-cm, Grade II tumor, ER 90%, PR 60% and three positive nodes?
How would you generally compare the
overall profile
of an aromatase inhibitor (AI) up front
versus
tamoxifen for two to three years followed by an AI for a woman in average health with a 1.2-cm, Grade II tumor, ER 90%, PR 60% and three positive nodes?
Consider a breast cancer patient receiving oral adjuvant endocrine therapy. For what percentage of the time do you think the patient would take her medication as prescribed? (mean)
How often during routine follow-up visits with patients on long-term adjuvant endocrine therapy do you ask your patients how regularly they take their medication?
Which one of the following best describes how you have used an aromatase inhibitor
outside of a clinical trial
for a breast cancer patient with DCIS (ductal carcinoma in situ)?
