Adjuvant Endocrine Therapy for Women With Hormone Receptor–Positive Breast Cancer

Many women with node-negative breast cancer are potential candidates for and may be offered extended AI therapy for up to a total of 10 years of adjuvant endocrine treatment based on considerations of recurrence risk using established prognostic factors. However, as the recurrence risk is lower, the benefits are likely narrower for such patients. Women with low-risk node-negative tumors should not routinely be offered extended therapy. (, , )

Women with node-positive breast cancer should be offered extended AI therapy for up to a total of 10 years of adjuvant endocrine treatment. (, , )

Women receiving extended adjuvant endocrine therapy should receive no more than 10 years of total treatment. (, , )

As prevention of secondary or contralateral breast cancers is a major benefit of extended AI therapy, the risk of second breast cancers (or not) based on prior therapy should inform the decision to pursue extended treatment. (, , )

Extended therapy carries ongoing risks and side effects, which should be weighed against the potential absolute benefits of longer treatment in a shared decision-making process between the clinical team and the patient. (, , )