The impact of adjuvant therapy for treatment of early stage breast cancer
has clearly reduced the risk of disease recurrence and breast cancer mortality.
The evolution of adjuvant therapy for treatment of early stage breast cancer
is a story of incrementalism, built on the solid observation made more 3 decades
ago that administration of postoperative chemotherapy improves outcome for
patients with breast cancer.1 Numerous large
randomized clinical trials have subsequently reaffirmed that early observation.2 With the characterization of the estrogen receptor
(ER) and the introduction of tamoxifen, adjuvant endocrine therapy proved
to be highly effective as another, although not mutually exclusive, systemic
approach for treatment of patients with tumors expressing ER. Additionally,
the benefit of tamoxifen conferred to patients with tumors expressing ER is
fairly similar across age groups.2 More recently,
the introduction of selective aromatase inhibitors as adjuvant endocrine therapy
in postmenopausal women appears to have incrementally improved outcome compared
with tamoxifen alone.3- 7
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