[Results and limits of endocrine therapy of carcinoma of the breast].
This review of endocrine therapy in breast carcinoma has been prepared principally with the aim of listing many persisting controversies in this area, even if significant advances have been made after the hormone receptor determination became available. Endocrine treatments include those indicated in an adjuvant setting and in metastatic disease. Indications for adjuvant endocrine therapy are still uncertain, even if a better selection of patients and the use of a non-toxic drug such as tamoxifen made more rationale and safer this type of treatment. Uncertainty is related to some doubts concerning consistency of survival advantages and to the relationship between advantages possibly obtainable by endocrine therapy or by adjuvant cytotoxic chemotherapy. Endocrine therapy can be cautiously combined with chemotherapy in amy adjuvant setting, as detrimental effects have been reported in some subsets of patients. Indications for endocrine treatment are mostly related to advanced disease, where more favourable results can presently be obtained through a better selection of patients and by less toxic hormone manipulations which are now available. In advanced disease, a sequential use of endocrine therapy and chemotherapy, or vice versa, is preferable to a concurrent administration of both types of treatment. Only some particular clinical situations suggest the latter type of approach. Some uncertainties are still present about the criteria by which, in the sequence, priority should be given to either therapeutic modality.
D001706:Biopsy; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D004965:Estrogen Antagonists / Q000627:therapeutic use; D004967:Estrogens / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis
D004965:Estrogen Antagonists; D004967:Estrogens; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone
Indicazioni e limiti della terapia endocrina nel carcinoma della mammella.