Adjuvant endocrine therapy for perimenopausal women with early breast cancer.
Adjuvant treatment with aromatase inhibitors (AIs) improves outcomes in postmenopausal women with hormone-sensitive early breast cancer compared with tamoxifen. However, AIs should not be used in premenopausal women because they can paradoxically increase estrogen secretion and may therefore stimulate tumor progression. In perimenopausal women undergoing treatment for breast cancer, it can be difficult to determine true menopausal status because adjuvant chemotherapy, tamoxifen, and gonadotropin-releasing hormone analogues can induce transient (or permanent) ovarian suppression. How can one determine whether these women are truly postmenopausal and therefore candidates for AI therapy? A panel of experts in the field of endocrine therapy in breast cancer met in Dubrovnik, Croatia, on October 23, 2006, to discuss this clinical dilemma. This report summarizes the conclusions and recommendations that arose from this discussion.
Ortmann
Olaf
O
Department of Obstetrics and Gynecology, University of Regensburg, Caritas-Hospital St. Josef, Regensburg, Germany. ortmann@caritasstjosef.de
Cufer
Tanja
T
Dixon
J Michael
JM
Maass
Nicolai
N
Marchetti
Paolo
P
Pagani
Olivia
O
Pronzato
Paolo
P
Semiglazov
Vladimir
V
Spano
Jean-Philippe
JP
Vrdoljak
Eduard
E
Wildiers
Hans
H
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy*; D010052:Ovariectomy; D010053:Ovary / Q000503:physiopathology; D018579:Patient Selection; D047648:Perimenopause; D017698:Postmenopause; D013629:Tamoxifen / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D013629:Tamoxifen