Initialization of adjuvant hormonal treatment for breast cancer |
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Authors: | Antonia Martínez Guisado Alfonso Sánchez Muñoz María de la Cabeza Lomas Garrido Manuel Ruíz Borrego Juan Bayo Calero Rubén de Toro Salas R. González Mancha Juan de la Haba Rodríguez Emilio Alba Conejo |
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Affiliation: | 1.Oncology Department,Hospital Torrecardenas,Almeria,Spain;2.Oncology Department,Hospital Clínico de Málaga,Málaga,Spain;3.Oncology Department,Hospital Médico Quirúrgico,Ciudad de Jaén,Spain;4.Oncology Department,Hospital Universitario Virgen del Rocío,Sevilla,Spain;5.Oncology Department,Hospital de Huelva,Huelva,Spain;6.Oncology Department,Hospital de Jerez de la Frontera,Jerez de la Frontera,Spain;7.Oncology Department,Hospital Universtario Reina Sofía,Córdoba,Spain;8.Universitario Virgen de la Victoria Campus Universitario de Teatinos,Málaga,Spain |
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Abstract: | The introduction of aromatase inhibitors (AI) has resulted in practice change approaches in the treatment of early breast cancer. In this paper, we analyze the most relevant studies including the ATAC, BIG 1-98, TEAM, MA-17, NSABP B-33, and ABSCG-6 studies. Postmenopausal patients with hormone receptor-positive early breast cancer should be treated with AI for 5 years. For patients who have been initiated with tamoxifen (TAM), switching to an AI to complete 5 years of treatment is also recommended. The results of the extended adjuvant therapy studies recommend the use of an AI (anastrozole, letrozole, or exemestane) after the completion of standard TAM treatment. With regards to premenopausal women, TAM is the recommended adjuvant hormonal treatment for pre- and perimenopausal women. There is no indication for the use of AI in these subgroups of patients. Finally, determination of CYP 2D6 polymorphisms could be considered when choosing the best adjuvant hormonal treatment option. |
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