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Review
. 2020 Aug;47(4):187-200.
doi: 10.1053/j.seminoncol.2020.05.010. Epub 2020 Jun 3.

Management of hormone receptor-positive, HER2-negative early breast cancer

Elaine M Walsh  1 , Karen L Smith  1 , Vered Stearns  2
Affiliations
Review

Management of hormone receptor-positive, HER2-negative early breast cancer

Elaine M Walsh et al. Semin Oncol. 2020 Aug.

Abstract

The majority of breast cancers are diagnosed at an early stage and are hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative. Significant advances have been made in the management of early stage HR-positive, HER2-negative breast cancer, resulting in improved survival outcomes. In this review, we discuss important factors to consider in the management of this disease. In particular, we discuss the role of adjuvant endocrine therapy, specific endocrine therapy agents, the duration of adjuvant endocrine therapy, treatment-related side effects, and the role of genomic assays and other biomarkers when considering treatment recommendations for individuals with HR-positive, HER2-negative early breast cancer. Finally, we address emerging data to individualize therapeutic decision-making and provide future considerations.

Keywords: Breast cancer; Endocrine therapy; Hormone receptor.

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Figures

Figure 1:
Figure 1:. Suggested Adjuvant Endocrine Therapy Approach for Women who are Pre-Menopausal at Diagnosis
AI: Aromatase Inhibitor; ET: Endocrine Therapy; OFS: Ovarian Function Suppression *High risk disease defined as tumors with lymph node involvement or aggressive histological features. In lymph node negative disease, high risk defined as young patient age, large tumor size or poor prognosis identified by genomic assays ^ There are currently no available data regarding the use of extended OFS beyond 5 years in patients who are deemed candidates for extended endocrine therapy
Figure 2:
Figure 2:. Suggested Adjuvant Endocrine Therapy Approach for Women who are Post-Menopausal at Diagnosis
AI: Aromatase Inhibitor; ET: Endocrine Therapy; *High risk disease defined as tumors with lymph node involvement or aggressive histological features. In lymph node negative disease, high risk defined as large tumor size or poor prognosis identified by genomic assays ^ Extended tamoxifen may be appropriate in post-menopausal patients if toxicities or contraindications to AI
See this image and copyright information in PMC

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