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William J. Gradishar, Meena S. Moran, Jame Abraham, Rebecca Aft, Doreen Agnese, Kimberly H. Allison, Bethany Anderson, Harold J. Burstein, Helen Chew, Chau Dang, Anthony D. Elias, Sharon H. Giordano, Matthew P. Goetz, Lori J. Goldstein, Sara A. Hurvitz, Steven J. Isakoff, Rachel C. Jankowitz, Sara H. Javid, Jairam Krishnamurthy, Marilyn Leitch, Janice Lyons, Joanne Mortimer, Sameer A. Patel, Lori J. Pierce, Laura H. Rosenberger, Hope S. Rugo, Amy Sitapati, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, Erica M. Stringer-Reasor, Melinda L. Telli, John H. Ward, Kari B. Wisinski, Jessica S. Young, Jennifer Burns, and Rashmi Kumar

that took into account factors associated with lower IBTR, including grade, ER positive status, use of adjuvant tamoxifen, margin status, and age, the benefit of RT boost still remained statistically significant (HR, 0.69; 95% CI, 0.53–0.91; P <.010

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Erin Currin, Lanell M. Peterson, Erin K. Schubert, Jeanne M. Link, Kenneth A. Krohn, Robert B. Livingston, David A. Mankoff, and Hannah M. Linden

lack of an accessible nonbone site of metastasis and patient refusal. She was treated with tamoxifen and bisphosphonate therapy with symptomatic improvement, with decline in tumor extent as measured by MRI and FDG-PET ( Figure 1, C ). Because of

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Jill R. Tichy, Elgene Lim, and Carey K. Anders

course. This section addresses endocrine therapy in adjuvant and metastatic settings, the controversy of ovarian suppression, and strategies with cytotoxic chemotherapy/targeted agents. Endocrine Therapy: Adjuvant Setting Adjuvant tamoxifen in

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Julie R. Gralow, J. Sybil Biermann, Azeez Farooki, Monica N. Fornier, Robert F. Gagel, Rashmi N. Kumar, Charles L. Shapiro, Andrew Shields, Matthew R. Smith, Sandy Srinivas, and Catherine H. Van Poznak

postmenopausal osteoporotic women in a randomized trial of raloxifene . J Natl Cancer Inst 2004 ; 96 : 1751 – 1761 . 68 Vogel VG Costantino JP Wickerham DL . Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and

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Omalkhair Abulkhair, Nagi Saghir, Lobna Sedky, Ahmed Saadedin, Heba Elzahwary, Neelam Siddiqui, Mervat Al Saleh, Fady Geara, Nuha Birido, Nadia Al-Eissa, Sana Al Sukhun, Huda Abdulkareem, Menar Mohamed Ayoub, Fawaz Deirawan, Salah Fayaz, Alaa Kandil, Sami Khatib, Mufid El-Mistiri, Dorria Salem, El Siah Hassan Sayd, Mohammed Jaloudi, Mohammad Jahanzeb, and William I. Gradishar

. Adjuvant Tamoxifen (Surveillance/Follow-up) Recommendations: Treatment with adjuvant tamoxifen during surveillance and follow-up should be considered a category 1 recommendation. Justification: In contrast to the findings reported by NSABP B-24, other

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NCCN Guidelines Insights: Breast Cancer, Version 3.2018

Featured Updates to the NCCN Guidelines

Matthew P. Goetz, William J. Gradishar, Benjamin O. Anderson, Jame Abraham, Rebecca Aft, Kimberly H. Allison, Sarah L. Blair, Harold J. Burstein, Chau Dang, Anthony D. Elias, William B. Farrar, Sharon H. Giordano, Lori J. Goldstein, Steven J. Isakoff, Janice Lyons, P. Kelly Marcom, Ingrid A. Mayer, Meena S. Moran, Joanne Mortimer, Ruth M. O'Regan, Sameer A. Patel, Lori J. Pierce, Elizabeth C. Reed, Hope S. Rugo, Amy Sitapati, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, Melinda L. Telli, John H. Ward, Jessica S. Young, Dorothy A. Shead, and Rashmi Kumar

evaluated breast cancer specimens from node-positive, HR-positive postmenopausal women (N=367) randomized to endocrine therapy with tamoxifen alone or chemotherapy with CAF (cyclophosphamide/doxorubicin/fluorouracil) followed by tamoxifen. 6 Compared with

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Josh Lauring, Ben Ho Park, and Antonio C. Wolff

cell lines and resensitize these cells to hormonal therapies, including tamoxifen and aromatase inhibitors. 20 , 23 , 25 - 28 In contrast, other studies have not found an increased sensitivity of LTED cells to dual PI3-kinase/mTOR inhibitors, and LTED

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Charles J. Ryan and Eric J. Small

herbal supplement, PC-SPES vs. diethylstilbestrol (DES) in patients with advanced, androgen independent prostate cancer (AiPCa) (Abstr #709) . Proc Am Soc Clin Oncol , 2002 ; 21 . 28 Glick JH Wein A Torri S . Phase II study of tamoxifen in

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Mindy E. Goldman

hormone replacement therapy tend to abruptly stop when diagnosed with endocrine-dependent cancers; and vasomotor symptoms are common with hormonal drugs such as tamoxifen or aromatase inhibitors. For Dr. Goldman, the key is to be sure that menopausal

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David Scott Miller, Gini Fleming, and Marcus E. Randall

Oncology Group study . J Clin Oncol 1996 ; 14 : 357 – 361 . 19 Fiorica JV Brunetto VL Hanjani P . Phase II trial of alternating courses of megestrol acetate and tamoxifen in advanced endometrial carcinoma: a Gynecologic Oncology Group study