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William J. Gradishar, Benjamin O. Anderson, Ron Balassanian, Sarah L. Blair, Harold J. Burstein, Amy Cyr, Anthony D. Elias, William B. Farrar, Andres Forero, Sharon Hermes Giordano, Matthew Goetz, Lori J. Goldstein, Clifford A. Hudis, Steven J. Isakoff, P. Kelly Marcom, Ingrid A. Mayer, Beryl McCormick, Meena Moran, Sameer A. Patel, Lori J. Pierce, Elizabeth C. Reed, Kilian E. Salerno, Lee S. Schwartzberg, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, George Somlo, Melinda Telli, John H. Ward, Dottie A. Shead, and Rashmi Kumar

Cancer Network, Inc. 2015, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®. the panel, the endocrine therapy options include an aromatase inhibitor

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Courtney P. Williams, Andres Azuero, Kelly M. Kenzik, Maria Pisu, Ryan D. Nipp, Smita Bhatia, and Gabrielle B. Rocque

effects of aromatase inhibitors versus tamoxifen: the patients’ perspective . Am J Surg 2006 ; 192 : 496 – 498 . 16978958 10.1016/j.amjsurg.2006.06.018 25. Vogel CL , Cobleigh MA , Tripathy D , . First-line Herceptin monotherapy in metastatic

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Samuel Martel, Matteo Lambertini, Dominique Agbor-Tarh, Noam F. Ponde, Andrea Gombos, Vicki Paterson, Florentine Hilbers, Larissa Korde, Anna Manukyants, Amylou Dueck, Christian Maurer, Martine Piccart, Alvaro Moreno-Aspitia, Christine Desmedt, Serena Di Cosimo, and Evandro de Azambuja

with obesity were more likely to have been treated with mastectomy ( P <.001), anthracycline-based chemotherapy ( P <.001), and aromatase inhibitors ( P <.001) ( Table 1 ). Table 1. Patient Demographics and Clinical Characteristics by BMI a Prognostic

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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

“consider checking 25-hydroxy vitamin D levels.” Justification: Insufficient and deficient vitamin D levels have been associated with poorer outcome among women with breast cancer in Canada. 32 Aromatase inhibitors can cause secondary osteopenia and

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chemotherapy. Methods: This study used the MarketScan and PharMetrics claims databases (January 1, 2002–June 30, 2014) to identify postmenopausal women with HR+/HER2− mBC who failed a nonsteroidal aromatase inhibitor and later initiated a new line of therapy

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Wui-Jin Koh, Benjamin E. Greer, Nadeem R. Abu-Rustum, Sachin M. Apte, Susana M. Campos, John Chan, Kathleen R. Cho, David Cohn, Marta Ann Crispens, Nefertiti DuPont, Patricia J. Eifel, Amanda Nickles Fader, Christine M. Fisher, David K. Gaffney, Suzanne George, Ernest Han, Warner K. Huh, John R. Lurain III, Lainie Martin, David Mutch, Steven W. Remmenga, R. Kevin Reynolds, William Small Jr, Nelson Teng, Todd Tillmanns, Fidel A. Valea, Nicole McMillian, and Miranda Hughes

with low toxicity in patients with low-grade tumors. 111 Tamoxifen with alternating megestrol may be used. 112 Aromatase inhibitors have also been used. 113 - 116 Adjuvant Therapy: Thorough surgical staging provides important information to assist

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Robert W. Carlson, Susan J. Moench, M. Elizabeth H. Hammond, Edith A. Perez, Harold J. Burstein, D. Craig Allred, Charles L. Vogel, Lori J. Goldstein, George Somlo, William J. Gradishar, Clifford A. Hudis, Mohammad Jahanzeb, Azadeh Stark, Antonio C. Wolff, Michael F. Press, Eric P. Winer, Soonmyung Paik, Britt-Marie Ljung, and for the NCCN HER2 Testing in Breast Cancer Task Force

amplification and response to either tamoxifen or aromatase inhibitors. 85 , 88 – 91 Despite inconsistent data, however, HER2 status has been, and may continue to be, considered in clinical decision-making involving hormonal therapies. 92 Trastuzumab with

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Wui-Jin Koh, Nadeem R. Abu-Rustum, Sarah Bean, Kristin Bradley, Susana M. Campos, Kathleen R. Cho, Hye Sook Chon, Christina Chu, David Cohn, Marta Ann Crispens, Shari Damast, Oliver Dorigo, Patricia J. Eifel, Christine M. Fisher, Peter Frederick, David K. Gaffney, Suzanne George, Ernest Han, Susan Higgins, Warner K. Huh, John R. Lurain III, Andrea Mariani, David Mutch, Christa Nagel, Larissa Nekhlyudov, Amanda Nickles Fader, Steven W. Remmenga, R. Kevin Reynolds, Todd Tillmanns, Stefanie Ueda, Emily Wyse, Catheryn M. Yashar, Nicole R. McMillian, and Jillian L. Scavone

–6 months). 40 , 157 Progesterone-based therapy has been shown to provide some benefit with low toxicity in patients with low-grade tumors. 158 Tamoxifen with alternating megestrol 159 and aromatase inhibitors has also been used. 160 – 163 For suspected

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Robert J. Morgan Jr, Deborah K. Armstrong, Ronald D. Alvarez, Jamie N. Bakkum-Gamez, Kian Behbakht, Lee-may Chen, Larry Copeland, Marta Ann Crispens, Maria DeRosa, Oliver Dorigo, David M. Gershenson, Heidi J. Gray, Ardeshir Hakam, Laura J. Havrilesky, Carolyn Johnston, Shashikant Lele, Lainie Martin, Ursula A. Matulonis, David M. O'Malley, Richard T. Penson, Sanja Percac-Lima, Mario Pineda, Steven C. Plaxe, Matthew A. Powell, Elena Ratner, Steven W. Remmenga, Peter G. Rose, Paul Sabbatini, Joseph T. Santoso, Theresa L. Werner, Jennifer Burns, and Miranda Hughes

LCOH-9 and OV-B, 6 of 7; pages 1143 and 1147, respectively). 200 , 212 – 215 Cytotoxic recurrence therapy includes docetaxel, paclitaxel, paclitaxel/ifosfamide, paclitaxel/carboplatin, and VAC. Hormone recurrence therapy includes aromatase inhibitors

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Mary B. Daly, Tuya Pal, Michael P. Berry, Saundra S. Buys, Patricia Dickson, Susan M. Domchek, Ahmed Elkhanany, Susan Friedman, Michael Goggins, Mollie L. Hutton, CGC, Beth Y. Karlan, Seema Khan, Catherine Klein, Wendy Kohlmann, CGC, Allison W. Kurian, Christine Laronga, Jennifer K. Litton, Julie S. Mak, LCGC, Carolyn S. Menendez, Sofia D. Merajver, Barbara S. Norquist, Kenneth Offit, Holly J. Pederson, Gwen Reiser, CGC, Leigha Senter-Jamieson, CGC, Kristen Mahoney Shannon, Rebecca Shatsky, Kala Visvanathan, Jeffrey N. Weitzel, Myra J. Wick, Kari B. Wisinski, Matthew B. Yurgelun, Susan D. Darlow, and Mary A. Dwyer

likelihood of benefit with these chemopreventive approaches in individual patients. The aromatase inhibitors (AIs) exemestane and anastrozole have been demonstrated to be effective in preventing breast cancer in postmenopausal women considered to be high