© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 21, 1599,
November 7, 2001
© 2001 Oxford University Press
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New Guidelines Endorse Widespread Use of Hormonal Therapy for Breast Cancer
Treatment of primary breast cancer should depend, first and foremost, on hormonal status of tumors, an international panel of oncologists has recommended.
The Seventh International Conference on Adjuvant Therapy of Primary Breast Cancer developed guidelines advising that all patients with endocrine-responsive tumors receive anti-hormonal therapy, including those at minimal risk of recurrence (defined as a 10% risk at 10 years). The panel further lowered the threshold defining endocrine-responsive disease to tumors containing as few as 1% of cells that stain positive for steroid hormone receptors.
The panel conference, representing several thousand delegates from 70 countries, was held in February in St. Gallen, Switzerland, and its consensus recommendations were summarized in the Sept. 15 issue of the Journal of Clinical Oncology.
The last set of guidelines, issued in 1998, supported a more limited use of endocrine-based therapy, but recent research has convinced the oncology community otherwise, said panel organizer Hans-Jörg Senn, M.D., of the Zentrum für Tumordiagnostik und Prävention, in St. Gallen, Switzerland. "Modern anti-endocrine therapy has been shown to be both effective and well tolerated by patients," he said.
Postmenopausal women have the greatest prevalence of hormone-positive tumors, and more than one-third of breast cancer in women of childbearing age is estrogen dependent.
The panel also highlighted several other important advances, including: the importance of factoring patient preferences into treatment decisions; the value of sentinel lymph node biopsy in avoiding extensive surgery; and incorporation of new agents and improved outcomes in treatment of breast cancer.
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