NCCN Guidelines for Patients® | Stages I and II Breast Cancer - page 64

Hormone therapy recommendations
| Premenopausal women
Initial treatment
Extended treatment
Tamoxifen for 5 years ± ovarian
suppression or ablation
If still premenopausal:
• Consider taking tamoxifen for another 5 years, or
• Stop taking hormone therapy
If postmenopausal:
• Take aromatase inhibitors for 5 years, or
• Consider taking tamoxifen for another 5 years
NCCN Guidelines for Patients
Stages I and II Breast Cancer, Version 1.2014
Hormone therapy
Hormone therapy regimens
Hormone therapy regimens
Recommended drugs
Which hormone therapy you should take is based on
your menopausal status. Menopause is the point in
time when you won’t have another menstrual period
again. If you haven’t had a menstrual period in the
past year, you are considered postmenopausal.
Breast cancer doctors also define menopause as
when the ovaries aren’t able to make high levels of
If you were having menstrual periods
(premenopausal) before starting chemotherapy, the
absence of menstrual periods after chemotherapy
doesn’t mean you’re postmenopausal. Your ovaries
may still be working despite no menstrual periods or
may start working again. To confirm your menopausal
status, the amount of estrogen or FSH (
ormone) in your blood needs to be
tested. If you are taking LHRH agonists, it isn’t
possible to know your menopausal status.
Hormone therapy drugs are usually taken for 5 to 10
years. The first hormone therapy taken is the initial
treatment. Sometimes a second type of hormone
therapy is taken within the 5-year period. This is
called sequential treatment. Hormone therapy
taken beyond the 5-year period is called extended
Premenopausal women
If you still have menstrual periods, tamoxifen is
recommended. Initial treatment with tamoxifen is for
5 years. Ovarian ablation or suppression may be
added to tamoxifen. After 5 years of tamoxifen, your
menstrual status will be assessed again. If you are
still premenopausal, you may stop hormone therapy
or consider taking tamoxifen for another 5 years. If
you’re postmenopausal, taking an aromatase inhibitor
for up to 5 years is recommended or consider taking
tamoxifen for another 5 years. The hormone therapy
recommendations for premenopausal women are
listed in the chart below.
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