Adjuvant hormonal therapy in perimenopausal patients

Adv Ther. 2011 Sep:28 Suppl 6:39-49. doi: 10.1007/s12325-011-0023-3. Epub 2011 Sep 16.

Abstract

This section considers the treatment options for perimenopausal women with breast cancer. The perimenopause period begins in the so-called stage 2 of menopausal transition (early menopausal transition, where the length of the cycles changes by 7 days or more) and ends after 12 months of amenorrhea. It is characterized by an early increase in follicle-stimulating hormone and is associated with the presence of anovulatory cycles, irregular periods, and loss of menstrual cycles. The recommended treatment is tamoxifen (TAM) with or without ovarian ablation for 2 or 3 years followed by a re-evaluation. TAM should be maintained if the patient is premenopausal and aromatase inhibitors (AI) are recommended once the menopausal status is confirmed. Ovarian suppression is an acceptable adjuvant therapy in those patients with hormone-sensitive tumors. AI should only be used in postmenopausal women or in combination with chemical castration in premenopausal women. This supplement paper includes the key points of roundtable presentations and discussions of hormonal therapy in breast cancer.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Age Factors
  • Antineoplastic Agents, Hormonal / administration & dosage*
  • Antineoplastic Agents, Hormonal / adverse effects
  • Aromatase Inhibitors / administration & dosage*
  • Aromatase Inhibitors / adverse effects
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Humans
  • Mastectomy / methods
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Patient Selection
  • Perimenopause / drug effects*
  • Perimenopause / physiology
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Survival Analysis
  • Tamoxifen / administration & dosage
  • Tamoxifen / adverse effects
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Hormonal
  • Aromatase Inhibitors
  • Tamoxifen