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NCCN Guidelines for Patients


Breast Cancer - Early-Stage


, Version 1.2016


Endocrine therapy


Options for endocrine therapy are based on your

menopausal status. All options involve taking an

antiestrogen, an aromatase inhibitor, or both back-to-

back. These medicines are usually taken for 5 to 10

years. The first regimen received is called the initial

treatment. Sometimes a second medicine is taken

within the 5-year period. This is called sequential

treatment. Endocrine therapy taken beyond the

5-year period is called extended treatment.

Chart 6.2

lists the two options for premenopausal

women. The first option is take tamoxifen. Initial

treatment with tamoxifen is for 5 years. Ovarian

ablation or suppression may be added.

After 5 years of tamoxifen, your menstrual status will

be assessed again. If you are still premenopausal,

you may stop endocrine therapy or consider

taking tamoxifen for another 5 years. If you’re

postmenopausal, taking an aromatase inhibitor for up

to 5 years is advised or consider taking tamoxifen for

another 5 years.

The second option for premenopausal women

includes ovarian suppression or ablation. This

treatment will cause menopause or start a

menopause-like phase. An aromatase inhibitor is then

taken for 5 years.

Chart 6.3

lists eight options for postmenopausal

women. One option is to take an aromatase inhibitor

for 5 years. Other options combine the use of an

aromatase inhibitor and tamoxifen. In some cases,

taking tamoxifen alone is an option. Treatment often

lasts for 5 years but sometimes will be taken for 10