Endocrine therapy of early breast cancer

Patients with steroid hormone receptor, i.e. positive early breast cancer receive endocrine therapy. Despite extensive knowledge on endocrine therapy not all questions are satisfactorily answered. For premenopause patients the question of the necessity of ovarian ablation and the duration has not yet been finally clarified. In the postmenopause aromatase inhibitors are firmly established but questions still remain on the optimal sequence and duration of therapy. According to the recent literature the tumor biology plays a significant role. The characteristic features of a tumor with respect to possible resistance to therapy require knowledge on the intracellular mechanisms of various signal pathways and possible cross-talk. This can result in combined therapy options from established endocrine strategies with other signal transduction inhibitors or antibodies as are well known in the metastasis situation. The discovery of new prognostic and predictive biomarkers has an influence on breast cancer therapy. This article presents the development of endocrine therapy and perspectives for the future.