title: New insights into endocrine therapy for young women with breast cancer.
abstract: Managing estrogen receptor-positive breast cancer in young women (<40 years) requires a multidisciplinary/personalized approach, covering both clinical and psychosocial aspects. Five years of tamoxifen has been the standard adjuvant endocrine therapy for many years. Recent data from the adjuvant randomized trials TEXT-SOFT show that the aromatase inhibitor exemestane plus ovarian suppression significantly reduces recurrences as compared with tamoxifen plus ovarian suppression. The ATLAS and aTToM trials represent the first evidence of a beneficial effect of extended endocrine therapy with tamoxifen in premenopausal women. Outside of a clinical trial, no data support neoadjuvant endocrine therapy in young women. In the metastatic setting, tamoxifen or aromatase inhibitors, both with ovarian suppression/ablation, should be the preferred choice, unless rapid tumor shrinkage is needed. No data are available with fulvestrant in young patients.
authors.affiliation: Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.|Breast Unit of Southern Switzerland (CSSI), Bellinzona, Switzerland.
authors.forename: Simona
authors.initials: S
authors.lastname: Di Lascio
authors.affiliation: Oncology Institute of Southern Switzerland (IOSI), Bellinzona, Switzerland.|Breast Unit of Southern Switzerland (CSSI), Bellinzona, Switzerland.
authors.forename: Olivia
authors.initials: O
authors.lastname: Pagani
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D004703:Endocrine System / Q000187:drug effects; D020847:Estrogen Receptor Modulators / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D013629:Tamoxifen / Q000627:therapeutic use
chemical_list: D018931:Antineoplastic Agents, Hormonal; D020847:Estrogen Receptor Modulators; D013629:Tamoxifen
keywords: advanced breast cancer; early breast cancer; endocrine therapy; exemestane; ovarian suppression; premenopausal; young women