title: Endocrine Therapy in Premenopausal Hormone Receptor-Positive Breast Cancer.
abstract: Systemic therapy for premenopausal women with hormone receptor-positive breast cancer has evolved in the last 5 years, but critical questions remain. Recent randomized trials have demonstrated a benefit for the addition of ovarian suppression to endocrine therapy in patients with breast cancers considered to be at high risk for recurrence, whereas those with lower-risk cancers seem to have a favorable outcome with tamoxifen alone. Two large randomized trials have demonstrated a benefit for extending adjuvant tamoxifen beyond 5 years. Currently the choice of systemic therapy is selected empirically but molecular profiling may, in the near future, provide a more conclusive means of selecting an endocrine therapeutic approach for premenopausal patients. Given that a significant subset of hormone receptor-positive cancers are intrinsically resistant to endocrine agents, as well as the finding that inhibiting cyclin-dependent kinases 4 and 6 and mammalian target of rapamycin appears to potentially reverse this resistance in patients with metastatic disease, evaluation of these agents in the early-stage setting is ongoing.
authors.affiliation: University of Wisconsin, Madison, WI.
authors.forename: Amye J
authors.initials: AJ
authors.lastname: Tevaarwerk
authors.affiliation: University of Wisconsin, Madison, WI.
authors.forename: Kari B
authors.initials: KB
authors.lastname: Wisinski
authors.affiliation: University of Wisconsin, Madison, WI.
authors.forename: Ruth M
authors.initials: RM
authors.lastname: O'Regan
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D010053:Ovary / Q000187:drug effects; D017697:Premenopause; D016032:Randomized Controlled Trials as Topic; D011987:Receptors, Steroid
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011987:Receptors, Steroid