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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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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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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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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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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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William J. Gradishar

were updated to indicate that women who are postmenopausal at diagnosis and received an AI for 5 years “can consider an AI for an additional 5 years.” 5 This includes women who received tamoxifen for 5 years and wish to extend endocrine therapy to 10

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Charles L. Loprinzi and Peter M. Ravdin

. Early Breast Cancer Trialists' Collaborative Group . Lancet 1998 ; 352 : 930 – 942 . 16 Anonymous : Tamoxifen for early breast cancer: An overview of randomized trials. Early Breast Cancer Trialists' Collaborative Group . Lancet 1998

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Sofia D. Merajver and Kara Milliron

. 13 Fisher B Costantino JP Wickerham DL . Tamoxifen for prevention of breast cancer: Report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study . J Natl Cancer Inst 1998 ; 90 : 1371 – 1388 . 14 Rockhill B Spiegelman