ADJUVANT ANTIHORMONE THERAPY

The development of effective, life-saving strategies for the adjuvant antihormone treatment of estrogen receptor (ER)–positive breast cancer is a major advance in medicine. The effectiveness of the long-term adjuvant tamoxifen therapy has saved perhaps millions of lives worldwide during the past 30 years. However, tamoxifen therapy for the postmenopausal patient has the concern of a small but significant increase in endometrial cancer and thromboembolic events. The innovation of blocking endogenous estrogen synthesis with aromatase inhibitors has not only reduced the side effects of tamoxifen with endometrial cancer and thromboembolic disorders but also enhanced survivorship. Tamoxifen remains the endocrine treatment of choice for the premenopausal patient.