title: Initialization of adjuvant hormonal treatment for breast cancer.
abstract: The introduction of aromatase inhibitors (AI) has resulted in practice change approaches in the treatment of early breast cancer. In this paper, we analyze the most relevant studies including the ATAC, BIG 1-98, TEAM, MA-17, NSABP B-33, and ABSCG-6 studies. Postmenopausal patients with hormone receptor-positive early breast cancer should be treated with AI for 5 years. For patients who have been initiated with tamoxifen (TAM), switching to an AI to complete 5 years of treatment is also recommended. The results of the extended adjuvant therapy studies recommend the use of an AI (anastrozole, letrozole, or exemestane) after the completion of standard TAM treatment. With regards to premenopausal women, TAM is the recommended adjuvant hormonal treatment for pre- and perimenopausal women. There is no indication for the use of AI in these subgroups of patients. Finally, determination of CYP 2D6 polymorphisms could be considered when choosing the best adjuvant hormonal treatment option.
authors.affiliation: Oncology Department, Hospital Torrecardenas, Almeria, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Martínez Guisado
authors.forename: A
authors.initials: A
authors.lastname: Sánchez Muñoz
authors.forename: M
authors.initials: M
authors.lastname: de la Cabeza Lomas Garrido
authors.forename: M
authors.initials: M
authors.lastname: Ruíz Borrego
authors.forename: J
authors.initials: J
authors.lastname: Bayo Calero
authors.forename: R
authors.initials: R
authors.lastname: de Toro Salas
authors.forename: R
authors.initials: R
authors.lastname: González Mancha
authors.forename: J
authors.initials: J
authors.lastname: de la Haba Rodríguez
authors.forename: E
authors.initials: E
authors.lastname: Alba Conejo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000077384:Anastrozole; D000730:Androstadienes / Q000008:administration & dosage / Q000009:adverse effects; D047072:Aromatase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D009570:Nitriles / Q000008:administration & dosage / Q000009:adverse effects; D017698:Postmenopause / Q000187:drug effects; D017697:Premenopause / Q000187:drug effects; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016019:Survival Analysis; D013629:Tamoxifen / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000730:Androstadienes; D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D013629:Tamoxifen; D000077384:Anastrozole; C056516:exemestane