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Adjuvant endocrine therapy for postmenopausal women with early stage breast cancer

Margaret Grant and Daniel W Rea

While surgery and radiation offer local control of the primary breast tumor, the principal aim of systemic adjuvant therapies is to prevent or delay distant metastases. A large number of randomized clinical trials over the past 20 years have demonstrated the importance of adjuvant endocrine therapy in reducing breast cancer mortality. For postmenopausal hormone receptor-positive patients, tamoxifen has been the standard of care in the adjuvant setting, however, recent developments have led to the introduction of new endocrine agents such as the third-generation aromatase inhibitors. Ongoing studies are evaluating the optimum duration of treatments and the combination and sequencing of different agents to prevent drug-resistance.