UNLABELLED

Adjuvant systemic therapy reduces the likelihood of both local and distant relapses by eradicating micrometastases.

AIM

To survey the adjuvant treatment of early breast cancer.

METHODS

Author presents an overview of the systemic therapy of early breast cancer based on relevant literature and own experiences.

RESULTS

Three systemic treatment modalities are widely used as adjuvant therapy for early stage breast cancer such as endocrine treatments, chemotherapy, and anti-HER2 therapy with the humanized monoclonal antibody, trastuzumab. As regards endocrine therapy, the most firmly established adjuvant therapy is tamoxifen for both premenopausal and postmenopausal women. Ovarian suppression and/or tamoxifen are accepted therapy for premenopausal patients. The third generation of aromatase inhibitors should be incorporated in the adjuvant endocrine therapy of postmenopausal women. Thus, it is not known whether initial, sequential, or extended use of adjuvant aromatase inhibitors is the optimal strategy. Adjuvant chemotherapy consisting of multiple cycles of polychemotherapy is an important strategy for lowering the risk of breast cancer recurrence and improving survival, not only in women with higher risk, but in node-negative patients, as well. The introduction of taxanes into treatment strategy constitutes an important advance over the traditional therapy with alkylator- and anthracycline-based regimens. The biologically-targeted drug, trastuzumab has been incorporated in the adjuvant management of HER2 positive tumors, and its duration of treatment is conventionally 1 year to date.

CONCLUSIONS

Adjuvant systemic treatment in breast cancer is a rapidly advancing field of clinical oncology. Taxane-based chemotherapy, aromatase inhibitors in the adjuvant endocrine therapy of postmenopausal women, and the availability of trastuzumab as adjuvant treatment have all led to substantial improvement in the outcome of early breast cancer.