Reducing early recurrence with adjuvant aromatase inhibitors: what is the evidence?
In early breast cancer, excision of the primary tumor, with or without radiotherapy and adjuvant chemotherapy or tamoxifen, is highly effective and yields long-term disease control for many patients. Some patients relapse early (within 2 years of surgery); such relapses are predominantly distant metastases and are associated with an increased risk for breast cancer-related mortality. The aromatase inhibitors (anastrozole, letrozole, and exemestane) have been shown to be superior to tamoxifen in improving disease-free survival in postmenopausal women with hormone receptor-positive breast cancer. Anastrozole and letrozole are approved in the initial adjuvant setting, and their use appears to be a better option than initial tamoxifen for preventing disease recurrence in the first 2 years of therapy, the peak time for recurrence and metastases. This review compares the ability of aromatase to prevent early recurrences, particularly distant metastases.
Dixon
J Michael
JM
Edinburgh Breast Unit, Western General Hospital, Edinburgh, EH4 2XU, UK. jmd@ed.ac.uk
D000970:Antineoplastic Agents / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D016462:Mammaplasty; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*
D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors