Adjuvant hormonal therapy in premenopausal women with operable breast cancer: not-so-peripheral perspectives.
Reviews of issues around adjuvant hormonal therapies for breast cancer in premenopausal women often focus on recent and current large clinical trials, and fail to address other subjects that are very germane to evidence-based and investigatory clinical practice. These topics include: (1) the descriptive epidemiology of breast cancer globally, (2) critical issues in tumor hormone receptor testing, (3) compelling data demonstrating that hormone receptor-positive breast cancer is a chronic disease, (4) data supportive of combined hormonal therapy with tamoxifen as the standard of care, and the limited justifications for awaiting the SOFT and TEXT trial results, (5) pharmacogenetic hypotheses with tamoxifen, (6) ethical issues in ovarian suppression vs ablative treatment, and (7) emerging data about the importance of primary tumor removal surgery itself and "surgical stress" in solid tumor management.
Love
Richard R
RR
The Ohio State University Comprehensive Cancer Center Columbus, Ohio, USA. richard.love@osumc.edu
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D010052:Ovariectomy; D017697:Premenopause; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone
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