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<p>Adjuvant endocrine therapy (ET) for a&#xa0;minimum duration of 5&#xa0;years remains the standard of care in hormone receptor-positive early breast cancer, with treatment extension recommended for patients at increased risk of recurrence. In postmenopausal women, aromatase inhibitors (AIs) or sequential strategies combining AIs and tamoxifen are preferred, while extended treatment durations of 7–10&#xa0;years are advocated for high-risk patients. In premenopausal women, tamoxifen represents the standard in low-risk disease, whereas patients at higher risk derive additional benefit from ovarian function suppression combined with tamoxifen or an AI; in selected cases with persistently elevated recurrence risk, further extension of tamoxifen therapy by an additional 5&#xa0;years may be considered. Given the high incidence of breast cancer, adjuvant ET represents a&#xa0;major public health issue: in Germany alone, approximately 70,000 women are newly diagnosed with breast cancer each year, of whom around 70–80% have hormone receptor-positive disease and are therefore candidates for long-term endocrine treatment. ET-associated adverse effects can lead to clinically relevant and persistent impairments in quality of life and should be adequately recognized and managed. Treatment adherence is critical for therapeutic efficacy, and switching to better-tolerated agents is generally preferable to premature discontinuation. Ongoing and emerging evidence is expected to further refine and individualize adjuvant ET strategies.</p>

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Endokrine Therapie des frühen Hormonrezeptor-positiven Mammakarzinoms

  • 期刊论文

  • 发表日期：

    2026年4月9日

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  • Henning Schäffler,
  • Wolfgang Janni,
  • Kristina Veselinovic,
  • Sabine Heublein

摘要

Adjuvant endocrine therapy (ET) for a minimum duration of 5 years remains the standard of care in hormone receptor-positive early breast cancer, with treatment extension recommended for patients at increased risk of recurrence. In postmenopausal women, aromatase inhibitors (AIs) or sequential strategies combining AIs and tamoxifen are preferred, while extended treatment durations of 7–10 years are advocated for high-risk patients. In premenopausal women, tamoxifen represents the standard in low-risk disease, whereas patients at higher risk derive additional benefit from ovarian function suppression combined with tamoxifen or an AI; in selected cases with persistently elevated recurrence risk, further extension of tamoxifen therapy by an additional 5 years may be considered. Given the high incidence of breast cancer, adjuvant ET represents a major public health issue: in Germany alone, approximately 70,000 women are newly diagnosed with breast cancer each year, of whom around 70–80% have hormone receptor-positive disease and are therefore candidates for long-term endocrine treatment. ET-associated adverse effects can lead to clinically relevant and persistent impairments in quality of life and should be adequately recognized and managed. Treatment adherence is critical for therapeutic efficacy, and switching to better-tolerated agents is generally preferable to premature discontinuation. Ongoing and emerging evidence is expected to further refine and individualize adjuvant ET strategies.