title: Comparing guidelines for adjuvant endocrine therapy in postmenopausal women with breast cancer: a coming of age.
abstract: Following surgery for early breast cancer, the standard of care for postmenopausal women is adjuvant therapy with any combination of radiation therapy, endocrine therapy, chemotherapy and/or targeted therapy. Clinicians rely on many tools, including guidelines, to make these treatment decisions. Such guidelines include the St Gallen consensus statement, the American Society of Clinical Oncology guidelines and the National Comprehensive Cancer Network guidelines, as well as various regional and national guidelines. Recommendations may vary, because different methods and criteria were used to assess the strength of supporting data. This article provides an overview of global guidelines for the adjuvant treatment of breast cancer and points out the major differences. Ongoing changes are highlighted, particularly those regarding the adjuvant endocrine treatment of postmenopausal women with breast cancer. While previous guidelines recommended tamoxifen alone, all major guidelines now recommend using third-generation aromatase inhibitors either in sequence with tamoxifen or as upfront treatment.
authors.affiliation: Department of Obstetrics and Gynecology and Breast Cancer Center, Klinikum Offenbach GmbH, Starkenburgring 66, D-63069 Offenbach, Germany.
authors.forename: Sunil
authors.initials: S
authors.lastname: Verma
authors.forename: Christian
authors.initials: C
authors.lastname: Jackisch
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D004703:Endocrine System / Q000502:physiology; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D017698:Postmenopause; D017410:Practice Guidelines as Topic; D013629:Tamoxifen / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D013629:Tamoxifen