Use of Endocrine Therapy for Breast Cancer Risk Reduction: ASCO Clinical Practice Guideline Update.
- Visvanathan K Johns Hopkins School of Medicine and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
- Fabian CJ University of Kansas Medical Center, Kansas City, KS.
- Bantug E Johns Hopkins School of Medicine, Baltimore, MD.
- Brewster AM University of Texas MD Anderson Cancer Center, Houston, TX.
- Davidson NE University of Washington, Seattle, WA.
- DeCensi A National Hospital E.O. Ospedali Galliera S.C. Oncologia Medica, Genoa, Italy; and Queen Mary University of London, United Kingdom.
- Floyd JD Cancer Care Specialists of Illinois, Swansea, IL.
- Garber JE Dana-Farber Cancer Institute, Boston, MA.
- Hofstatter EW Yale Cancer Center, New Haven, CT.
- Khan SA Northwestern University Feinberg School of Medicine, Chicago, IL.
- Katapodi MC University of Basel Nursing Science, Basel, Switzerland.
- Pruthi S Mayo Clinic Cancer Center, Rochester, MN.
- Raab R Cancer Care of Western North Carolina, Asheville, NC.
- Runowicz CD Florida International University, Miami, FL.
- Somerfield MR American Society of Clinical Oncology, Alexandria, VA.
- 2019-09-04
Published in:
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology. - 2019
Antineoplastic Agents, Hormonal
Breast Neoplasms
Female
Humans
Randomized Controlled Trials as Topic
English
PURPOSE
To update the ASCO guideline on pharmacologic interventions for breast cancer risk reduction and provide guidance on clinical issues that arise when deciding to use endocrine therapy for breast cancer risk reduction.
METHODS
An Expert Panel conducted targeted systematic literature reviews to identify new studies.
RESULTS
A randomized clinical trial that evaluated the use of anastrozole for reduction of estrogen receptor-positive breast cancers in postmenopausal women at increased risk of developing breast cancer provided the predominant basis for the update.
UPDATED RECOMMENDATIONS
In postmenopausal women at increased risk, the choice of endocrine therapy now includes anastrozole (1 mg/day) in addition to exemestane (25 mg/day), raloxifene (60 mg/day), or tamoxifen (20 mg/day). The decision regarding choice of endocrine therapy should take into consideration age, baseline comorbidities, and adverse effect profiles. Clinicians should not prescribe anastrozole, exemestane, or raloxifene for breast cancer risk reduction to premenopausal women. Tamoxifen 20 mg/day for 5 years is still considered standard of care for risk reduction in premenopausal women who are at least 35 years old and have completed childbearing. Data on low-dose tamoxifen as an alternative to the standard dose for both pre- and postmenopausal women with intraepithelial neoplasia are discussed in the Clinical Considerations section of this article. Additional information is available at www.asco.org/breast-cancer-guidelines.
To update the ASCO guideline on pharmacologic interventions for breast cancer risk reduction and provide guidance on clinical issues that arise when deciding to use endocrine therapy for breast cancer risk reduction.
METHODS
An Expert Panel conducted targeted systematic literature reviews to identify new studies.
RESULTS
A randomized clinical trial that evaluated the use of anastrozole for reduction of estrogen receptor-positive breast cancers in postmenopausal women at increased risk of developing breast cancer provided the predominant basis for the update.
UPDATED RECOMMENDATIONS
In postmenopausal women at increased risk, the choice of endocrine therapy now includes anastrozole (1 mg/day) in addition to exemestane (25 mg/day), raloxifene (60 mg/day), or tamoxifen (20 mg/day). The decision regarding choice of endocrine therapy should take into consideration age, baseline comorbidities, and adverse effect profiles. Clinicians should not prescribe anastrozole, exemestane, or raloxifene for breast cancer risk reduction to premenopausal women. Tamoxifen 20 mg/day for 5 years is still considered standard of care for risk reduction in premenopausal women who are at least 35 years old and have completed childbearing. Data on low-dose tamoxifen as an alternative to the standard dose for both pre- and postmenopausal women with intraepithelial neoplasia are discussed in the Clinical Considerations section of this article. Additional information is available at www.asco.org/breast-cancer-guidelines.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1200/JCO.19.01472
- PMID 31479306
- Persistent URL
- https://sonar.ch/global/documents/232537
Statistics
Document views: 45
File downloads:
- Full-text: 0