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Breast Cancer Treatment (Professional) (cont.)

Changes to This Summary (04/04/2013)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Stage I, II, IIIA, and Operable IIIC Breast Cancer

Added Davies et al. as reference 90.

Added text to state that it is controversial whether the optimal duration of adjuvant tamoxifen therapy in premenopausal women is 5 years or 10 years.

Added text to state that long-term follow-up of the Adjuvant Tamoxifen Longer Against Shorter (ATLAS) trial revealed that 10 years of tamoxifen reduced the risk of breast cancer recurrence, reduced breast cancer mortality, and reduced overall mortality (Level of evidence: 1iiA). Included text to list the risks of tamoxifen therapy after 10 years.

Added text to state that the cumulative risk of endometrial cancer during years 5 to 14 from breast cancer diagnosis was 3.1% for women who received 10 years of tamoxifen versus 1.6% for women who received 5 years of tamoxifen.

Added text to state that these trials raise important questions about the optimal duration of endocrine therapy. The long-term ATLAS data are really applicable for women who remain premenopausal after 5 years of tamoxifen therapy. Randomized clinical trial data support the use of aromatase inhibitors in postmenopausal women.

Added text to state that the mild androgen activity of exemestane prompted a randomized trial to evaluate whether exemestane might be preferable to anastrozole as upfront therapy for postmenopausal women who were diagnosed with hormone receptor-positive breast cancer (cited Goss et al. as reference 160 and level of evidence: IiiA). The NCIC CTG MA.27 (NCT00066573) trial randomly assigned 7,576 postmenopausal women to receive 5 years of anastrozole versus exemestane. Based on the results of this trial, no specific aromatase inhibitor is considered superior as upfront therapy for postmenopausal women with hormone receptor-positive breast cancer.

Stage IIIB, Inoperable IIIC, IV, Recurrent, and Metastatic Breast Cancer

Added Ado-Trastuzumab Emtansine as a new subsection.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.

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