Solving current dilemmas in the adjuvant endocrine treatment of pre- and perimenopausal women with an estrogen receptor positive breast cancer

In pre- and perimenopausal women with ER-positive HER2 negative breast cancer, 5 years of adjuvant tamoxifen (TAM) has been the standard of care for years. However, in some of these women with sufficiently high risk, we now consider extending (to 10 years TAM) and/or escalating endocrine treatment with ovarian function suppression (OFS) that can be combined safely with TAM but also with one of the three aromatase inhibitors (AIs). In this review, we will summarize our current policy on how to select patients at sufficient risk for relapse to consider OFS. We will also discuss the available data related to the choice of combining OFS with TAM or an AI, when to consider extended endocrine therapy, as well as the potential benefits of adding bone agents as part of treatment of these young patients.

ER-positive; HER2-negative; Ovarian function suppression; Adjuvant endocrine therapy; Premenopausal patients; Extended; Bone agents

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