Adjuvant systemic therapy of early stage breast cancer.
Adjuvant chemotherapy reduces the risk of recurrence and mortality in patients with early stage breast cancer. Anthracycline-based regimens are the most widely used standard in the United States. The inclusion of the taxanes into adjuvant chemotherapy programs offers an improvement in disease-free survival rates and probably overall survival rates compared to an anthracycline-based regimen alone. Although adjuvant chemotherapy is effective in all age groups, the magnitude of benefit is greatest in younger premenopausal patients. Treatment decisions need to be individualized. Dose-dense chemotherapy approaches are promising and can be considered an option for patients with early stage breast cancer. Adjuvant tamoxifen therapy should be administered for 5 years in patients with hormone receptor-positive breast cancer. Adjuvant tamoxifen should be administered after the completion of adjuvant chemotherapy. Data from the ATAC (Arimidex, tamoxifen, alone, or in combination) trial provide a compelling argument for choosing anastrozole as adjuvant endocrine therapy in postmenopausal women with hormone receptor-positive early stage breast cancer. Long-term follow-up of patients is necessary to determine the effects of chronic aromatase inhibitor treatment on bone density, cognitive function, and other endpoints.
Gradishar
William J
WJ
Division of Hematology/Oncology, The Feinberg School of Medicine, Northwestern University, 676 North St. Clair Street, Suite 850, Chicago, IL 60611, USA. w-gradishar@northwestern.edu
D047072:Aromatase Inhibitors; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D000077143:Docetaxel; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000031:analogs & derivatives* / Q000627:therapeutic use; D043823:Taxoids
D047072:Aromatase Inhibitors; D004791:Enzyme Inhibitors; D043823:Taxoids; D000077143:Docetaxel; D017239:Paclitaxel