Postmenopausal breast cancer. Adjuvant endocrine therapy

One of the main features of the adjuvant therapy in breast cancer is endocrine therapy. Up until 2005 tamoxifen was regarded as the "gold standard." However, results of large phase III trials have demonstrated that the aromatase inhibitors show a better outcome than the adjuvant therapy with tamoxifen alone. There are different aromatase inhibitor regimens: the upfront therapy consists of 5 years of an aromatase inhibitor, the sequential therapy changes between tamoxifen and an aromatase inhibitor after 2-3 years, and in the extended adjuvant therapy a 5-year treatment with tamoxifen is followed by 5 years of an aromatase inhibitor. Compared with tamoxifen monotherapy trials on upfront as well as a sequential or switch regimens demonstrate a significant improvement in disease-free survival. This effect was also shown for the extended adjuvant therapy in nodepositive patients. So far a significant difference regarding the overall survival has only been noted in the sequential therapy.