Should a patient be given extended endocrine therapy if she was on a lower dose than recommended for part of her treatment?

The patient is a pre-menopausal woman with low-grade, stage I IDC who initially could only tolerate 10 mg of tamoxifen for her first year of treatment. She then was able to tolerate 20 mg for the subsequent four years. Should she receive an extra year of 20 mg of tamoxifen?

1 Answer

Mednet Member

Medical Oncology · MOSC Medical College Kolenchery

Answered on

Two questions here:

1. Does she need extended endocrine therapy? Several extended endocrine therapy trials using AI or a switch strategy showed lack of a significant benefit with improving disease free survival (summarized here: https://www.healio.com/hematology-oncology/breast-cancer/news/print/hemonc-today/%7B5c1f7dbe-15c8-4775-a8b2-acb6e457d618%7D/does-the-efficacy-of-bisphosphonates-support-the-use-of-extended-aromatase-inhibitor-therapy-in-women-at-risk-for-bone-fractures) However, from the ATLAS and the aTTom trial, we know that extended use of tamoxifen improves recurrence free survival (summarized here: https://www.ncbi.nlm.nih.gov/pubmed/26255743). But the absolute gain in doing this is marginal for a woman who is at low risk for re...

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