Check out the latest career moves in Movers in Medicine. Skip to main content. Endocrine therapy in metastatic breast cancer: a closer look at the current clinical practice. JCSO ; How long you continue aromatase inhibitors depends on your specific situation. Current research suggests that the standard approach would be to take these medications for up to 10 years, but every person is different and you and your doctor should carefully assess how long you should take them.
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Women who haven't undergone menopause — either naturally or as a result of cancer treatment — may opt to undergo treatment to stop their ovaries from producing hormones. Treatments to stop ovarian function may allow premenopausal women to take medications only available to postmenopausal women. Hormone therapy for cancer that spreads to other parts of the body metastatic breast cancer sometimes combines hormone therapies with targeted therapy.
Targeted therapy drugs attack specific weaknesses in cancer cells. The combination can make hormone therapy more effective. You'll meet with your cancer doctor oncologist regularly for follow-up visits while you're taking hormone therapy for breast cancer. Your oncologist will ask about any side effects you're experiencing.
Many side effects can be controlled. Hormone therapy following surgery, radiation or chemotherapy has been shown to reduce the risk of breast cancer recurrence in people with early-stage hormone-sensitive breast cancers. It can also effectively reduce the risk of metastatic breast cancer growth and progression in people with hormone-sensitive tumors.
Depending on your circumstances, you may undergo tests to monitor your medical situation and watch for cancer recurrence or progression while you're taking hormone therapy. Results of these tests can give your doctor an idea of how you're responding to hormone therapy, and your therapy may be adjusted accordingly. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease. Mayo Clinic does not endorse companies or products.
Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Hormone therapy for breast cancer is a treatment for breast cancers that are sensitive to hormones.
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Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Benefits Smaller doses of anthracyclines can be used, which can reduce the risk of side effects such as nausea and vomiting. Side effects Additional side effects may include joint and muscle pain, nerve damage, higher rates of febrile neutropenia and hypersensitivity reactions.
Biological therapy 1. Bone health 1. Side effects In this group of women at low risk, there is no increase in serious late side effects of radiotherapy such as congestive cardiac failure, myocardial infarction or secondary cancer. No side effects of radiotherapy will occur. No need to attend the treatment centre for radiotherapy sessions. Radiotherapy after mastectomy 1. Dose fractionation 1. Radiotherapy to nodal areas 1.
Intraoperative radiotherapy 1. Neoadjuvant chemotherapy regimens 1. Bone marrow suppression and renal problems are likely in older people. Licensed status At the time of publication July , platinums did not have UK marketing authorisation for this indication. Neoadjuvant endocrine therapy 1.source
Table 7 Benefits and risks of neoadjuvant endocrine therapy compared with neoadjuvant chemotherapy Neoadjuvant endocrine therapy Neoadjuvant chemotherapy Definition Tamoxifen or an aromatase inhibitor started before surgery. Chemotherapy given before surgery.
Only an option for people who would be recommended adjuvant after surgery chemotherapy. Administration Tablet taken once a day at home. Intravenous administration in hospital, as an outpatient. Effectiveness For postmenopausal women: may be as effective as neoadjuvant chemotherapy in terms of breast conservation rates and shrinking the tumour. Potential disadvantages If neoadjuvant endocrine therapy is not effective, then women may proceed to surgery earlier or may still need to have chemotherapy, either before or after surgery.
For tamoxifen: increased risk of thrombosis and endometrial cancer. Side effects are usually reversible. Side effects may persist long term.
Often causes temporary infertility. May cause permanent infertility. The duration of neoadjuvant chemotherapy is shorter than neoadjuvant endocrine therapy. Radiotherapy after neoadjuvant chemotherapy 1. Arm mobility 1. Menopausal symptoms 1. This plan should include: designated named healthcare professionals dates for review of any adjuvant therapy details of surveillance mammography signs and symptoms to look for and seek advice on contact details for immediate referral to specialist care and contact details for support services, for example, support for people with lymphoedema.
Immediate breast reconstruction. Delayed breast reconstruction. Reconstruction is started in the same operation as the mastectomy. Number and timing of operations. Breast reconstruction options available. Certain options that spare or preserve the breast skin may not be available. Breast shape remains, which may have psychological benefits. Procedures and associated recovery can be planned around other commitments.
May be lower rates of: tissue breakdown surgery for flap removal if it cannot be used because of a complication which may lead to delayed reconstruction and flat appearance for a period of time procedures to improve symmetry. Complications from the mastectomy or axillary surgery can occur during the recovery period. May be lower rates of: mastectomy site complications flap or implant failure which may lead to delayed reconstruction and flat appearance for a period of time capsular contracture a scar layer around the implant that may lead to pain if severe.
May need to interrupt hormone therapies tamoxifen for further surgery. No clear differences in satisfaction with completed reconstructions.
Who can take this therapy. Fertility and family planning. Side effects. All endocrine therapies: menopausal symptoms such as hot flushes.
Combination endocrine therapy in the management of breast cancer.
Weekly or fortnightly paclitaxel. Effect on survival NOTE: The benefit for an individual person will depend on the risk of their cancer returning. Length of course. No radiotherapy. Effect on local recurrence. Effect on survival.
Related Endocrine Management of Breast Cancer
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