title: Adjuvant Endocrine Therapy in Premenopausal Patients.
abstract: Endocrine adjuvant therapy is the best-described molecular targeted treatment and should therefore be used for all patients with endocrine-responsive breast cancer. Ta-moxifen for 5 years is standard of care and has proven efficacy in premenopausal patients. The combination of tamoxifen with ovarian function suppression and/or chemotherapy has been extensively tested, and some controversial approaches are used in clinical practice. Cessation or suppression of ovarian function appears to be beneficial for premenopausal patients. Particularly for premenopausal women with highly endocrine-responsive disease and/or low risk for relapse, the additional benefit of cytotoxic chemotherapy may be minor or nonexistent. While the use aromatase inhibitors is investigated in clinical trials, their application outside an academic trial setting cannot be recommended based on first available results. In contrast, the use of adjuvant bispho-sphonates may offer another strategy of further improving clinical outcomes in this important patient subgroup.
authors.affiliation: Universitätsklinik für Chirurgie, Austrian Breast and Colorectal Cancer Study Group, Medizinische Universität Wien, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Gnant
references.citation: J Clin Oncol. 1999 May;17(5):1474-81
references.pmid: 10334533
references.citation: J Clin Oncol. 2001 Jan 15;19(2):343-53
references.pmid: 11208825
references.citation: Lancet. 2005 Aug 6-12;366(9484):455-62
references.pmid: 16084253
references.citation: Cancer. 2008 Mar 1;112(5):1001-10
references.pmid: 18205185
references.citation: J Clin Oncol. 2002 May 15;20(10):2559-66
references.pmid: 12011136
references.citation: Ann Oncol. 2007 Jul;18(7):1133-44
references.pmid: 17675394
references.citation: N Engl J Med. 2004 Mar 11;350(11):1081-92
references.pmid: 15014181
references.citation: Breast Cancer Res Treat. 1997 Apr;43(2):183-90
references.pmid: 9131274
references.citation: Lancet Oncol. 2008 Sep;9(9):840-9
references.pmid: 18718815
references.citation: J Clin Oncol. 2001 Sep 15;19(18):3808-16
references.pmid: 11559718
references.citation: Br J Cancer. 2005 Dec 12;93(12):1319-23
references.pmid: 16333242
references.citation: Lancet. 1998 May 16;351(9114):1451-67
references.pmid: 9605801
references.citation: Breast Cancer Res Treat. 2002 Nov;76(1):27-36
references.pmid: 12408373
references.citation: Lancet. 1996 Apr 20;347(9008):1066-71
references.pmid: 8602056
references.citation: Lancet. 2007 May 19;369(9574):1711-23
references.pmid: 17512856
references.citation: Lancet. 2002 Jun 22;359(9324):2131-9
references.pmid: 12090977
references.citation: Br J Cancer. 2004 Feb 9;90(3):590-4
references.pmid: 14760369
references.citation: Lancet. 2005 May 14-20;365(9472):1687-717
references.pmid: 15894097
references.citation: Cancer Metastasis Rev. 1989 Aug;8(2):98-101
references.pmid: 2673568
references.citation: Lancet. 2000 May 27;355(9218):1869-74
references.pmid: 10866443
references.citation: J Natl Cancer Inst. 2001 May 2;93(9):684-90
references.pmid: 11333290
references.citation: Eur J Cancer. 1998 Apr;34(5):606-8
references.pmid: 9713262
references.citation: N Engl J Med. 2005 Dec 29;353(26):2747-57
references.pmid: 16382061
references.citation: J Clin Oncol. 2007 Mar 1;25(7):829-36
references.pmid: 17159193
references.citation: J Natl Cancer Inst. 2005 Sep 7;97(17):1262-71
references.pmid: 16145047
references.citation: Lancet. 1996 Nov 2;348(9036):1189-96
references.pmid: 8898035
references.citation: J Clin Oncol. 2002 Dec 15;20(24):4611-4
references.pmid: 12488402
references.citation: BMJ. 1997 Oct 4;315(7112):863-6
references.pmid: 9353509
references.citation: Anticancer Res. 1999 May-Jun;19(3B):2261-8
references.pmid: 10472341
references.citation: Lancet Oncol. 2005 Aug;6(8):581-8
references.pmid: 16054569
references.citation: J Natl Cancer Inst. 2007 Dec 19;99(24):1845-53
references.pmid: 18073378
references.citation: Drugs. 2005;65(18):2639-55
references.pmid: 16392882
references.citation: J Clin Oncol. 2002 Dec 15;20(24):4621-7
references.pmid: 12488405
references.citation: J Natl Cancer Inst. 2002 Jul 17;94(14):1054-65
references.pmid: 12122096
references.citation: J Clin Oncol. 2002 Dec 15;20(24):4628-35
references.pmid: 12488406
references.citation: Lancet. 1998 Sep 19;352(9132):930-42
references.pmid: 9752815