Adjuvant Systemic Treatment in Hormone Receptor Positive, HER2 Negative Breast Cancer

Abstract

The introduction of adjuvant systemic therapy led to a significant improvement in postsurgical survival and a reduction in disease relapse. Approximately 75-80% of all breast cancers are hormone-dependent based on the presence of ER and/or PR on tumor cells. Patients with HR+ breast cancer less than 5 mm and treated with only endocrine therapy have usually very good prognosis. They typically are not treated with adjuvant chemotherapy. The patients with stage III HR+ breast cancer still require adjuvant chemotherapy since they carry high risk of recurrence without chemotherapy. Many patients with HR+ HER2 negative breast cancer fall in between these two categories, and they are called as intermediate risk group based on clinicopathological variables, genomic tests or online risk calculators. The minimum duration of adjuvant endocrine treatment is 5 years; however, patients with high risk factors including positive lymph node should be treated with the endocrine therapy up to 10 years either with tamoxifen alone or sequentially with aromatase inhibitors (AI) in postmenopausal women. Adjuvant bisphosphonates reduce bone recurrence and improve survival in postmenopausal women with early stage breast cancer.

Haploinsufficiency Interactions between RALBP1 and p53 in ERBB2 and PyVT Models of Mouse Mammary Carcinogenesis

“…Treatment strategies differ according to molecular subtype, and management of breast cancer requires a multidisciplinary approach, including locoregional (surgery and radiation therapy) and systemic approaches. Systemic therapies include endocrine therapy for hormone receptor-positive disease, chemotherapy, anti-HER2 therapy for HER2-positive disease, bone stabilizing agents, and poly (ADP-ribose) polymerase (PARP) inhibitors for BRCA mutation carriers [10]. Future therapeutic concepts in breast cancer aim at personalization of therapy as well as treatment based on tumor biology and on earlier detection and treatment initiation.…”