Postoperative adjuvant therapy for premenopausal patients with breast cancer

The age peak of breast cancer morbidity is younger in Japan in comparison with that in Western countries. This results in a higher incidence of premenopausal patients in Japan. There are specific concerns on the postoperative adjuvant therapy for premenopausal patients, such as its influences on pregnancy, delivery and lactation, and acute and chronic adverse events related to earlier ovarian dysfunction. International guidelines such as the recommendations by the St. Gallen consensus conference provide clinicians with useful information on the risk assessment for recurrence and treatment selection of postoperative adjuvant therapy. Recommendations on postoperative adjuvant therapy for premenopausal breast cancer patients are presented according to the guidelines and evidence established by clinical trials. On-going clinical trials to resolve unanswered questions on the adjuvant therapy are also reviewed. Finally, future perspectives on the adjuvant therapy are discussed.