Update on Adjuvant Endocrine Therapy in Breast Cancer

Abstract

Estrogen and progesterone are known to be the driving force in a significant number of breast cancers. Hormonal therapy has been used for many years to decrease the risk of breast cancer recurrence in patients with localized disease, originally in all patients, but now only in patients with tumors overexpressing estrogen and progesterone receptors. Tamoxifen became the gold standard of hormonal therapy after multiple clinical trials and meta-analyses proved its clinical benefits. Aromatase inhibitors have become increasingly important in the management of breast cancers with hormone receptor overexpression. Despite all the advancements, the optimal duration of adjuvant hormone therapy and the role of luteinizing hormone releasing hormone agonists in premenopausal women have not been fully elucidated. This article reviews the literature on adjuvant hormonal therapy in early stage breast cancer with an emphasis on the extended adjuvant tamoxifen trials ATLAS and aTTom, as well as the recently released TEXT and SOFT trial results looking at aromatase inhibitors in premenopausal women.