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The treatment of breast cancer involves interventions such as surgery, radiotherapy, chemotherapy, hormone therapy and biological therapy. This table outlines the guidance by NICE on the use of hormone therapy for breast cancer. Please also refer to the topic of aromatase inhibitors and breast cancer basics for a better understanding of this subject.
| Category | Patient Group | Recommendation |
|---|---|---|
| Endocrine Therapy | All with invasive breast cancer | Use surgery and systemic therapy, not just endocrine therapy, unless significant comorbidity exists. |
| Adjuvant Endocrine Therapy | Men and Premenopausal Women | Use tamoxifen for ER-positive tumors. |
| Postmenopausal Women | Use aromatase inhibitor for medium/high risk of disease recurrence and tamoxifen for low risk or if aromatase inhibitors are not tolerated. | |
| Ovarian Function Suppression | Premenopausal Women | Consider in addition to endocrine therapy for ER-positive tumors. Discuss benefits and risks. |
| Extended Endocrine Therapy (Beyond 5 years) | Suitable candidates | Discuss benefits and risks. |
| Postmenopausal Women (medium/high risk) | Offer aromatase inhibitor after 2-5 years of tamoxifen. | |
| Postmenopausal Women (low risk) | Consider aromatase inhibitor after 2-5 years of tamoxifen. | |
| All with ER-positive tumors | Consider extending tamoxifen duration beyond 5 years. | |
| Endocrine Therapy for DCIS | Women with ER-positive DCIS (post breast-conserving surgery) | Discuss benefits and risks. Offer therapy if radiotherapy is recommended but not... |
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