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Review
. 2025 Jul 16;61(7):1280.
doi: 10.3390/medicina61071280.

Current Endocrine Therapy in Hormone-Receptor-Positive Breast Cancer: From Tumor Biology to the Rationale for Therapeutic Tunning

Oana Maria Burciu  1 , Adrian-Grigore Merce  2 , Simona Cerbu  3 , Aida Iancu  4 , Tudor-Alexandru Popoiu  5 , Ionut Marcel Cobec  6   7 , Ioan Sas  8 , Gabriel Mihail Dimofte  9
Affiliations
Review

Current Endocrine Therapy in Hormone-Receptor-Positive Breast Cancer: From Tumor Biology to the Rationale for Therapeutic Tunning

Oana Maria Burciu et al. Medicina (Kaunas). .

Abstract

Background and Objectives: The objective of this review is to evaluate the current evidence regarding hormone treatments for both premenopausal and postmenopausal women with early-stage hormone receptor (HR) positive breast cancer. Materials and Methods: An in-depth exploration of the existing literature was conducted, with landmark clinical trials such as TEXT, SOFT, ATLAS, and aTTom serving as primary references. Results: Through an extensive review of the literature, our findings indicate that for premenopausal women with HR-positive, HER2-negative BC with a low risk of recurrence, standard 5-year monotherapy with tamoxifen represents the optimal therapeutic management, given its favorable clinical outcomes and lower associated toxicity. In contrast, for premenopausal women with an intermediate to high risk of recurrence with the same tumor characteristics, the most effective approach stated in the literature is a combination of ovarian suppression therapy (chemical/surgical) and an aromatase inhibitor/selective estrogen receptor modulator (tamoxifen), with a possible extension of the standard therapeutic period. In postmenopausal patients with HR-positive, HER2-negative breast cancer with a low recurrence risk, the first line of treatment is usually a standard 5-year period of treatment with aromatase inhibitors (AIs)(letrozole, anastrozole, or exemestane). On the other hand, in postmenopausal women with an intermediate to high risk, combination therapy might be needed, as well as an extension of the standard therapeutic time. Conclusions: Treatment consensus depends on pre- vs. postmenopausal status and recurrence risk.

Keywords: aromatase inhibitors; breast cancer; hormone therapy; tamoxifen.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Hallmarks of progression toward breast cancer. Created in BioRender (web version). Popoiu, T. (2025) https://BioRender.com/b53n45p (accessed on 22 April 2025).
Figure 2
Figure 2
Duration of adjuvant hormone therapy. Created in BioRender. Popoiu, T. (2025) https://BioRender.com/2nmc63o (accessed on 22 April 2025).
Figure 3
Figure 3
Adjuvant hormone therapy approach based on menopausal status. Created in BioRender. Popoiu, T. (2025) https://BioRender.com/b2babjn (accessed on 22 April 2025). Advanced stage = Stage III breast cancer; Early stage = Stage I–II breast cancer.
See this image and copyright information in PMC

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