SUMMARY

Five years used to be the standard duration for adjuvant endocrine therapy (ET) for hormone receptor-positive early breast cancers, but the benefit of extending treatment duration beyond this period to reduce the risk of disease recurrence has been investigated in several randomised trials, mostly including postmenopausal patients and investigating the extension of aromatase inhibitors as part of the ET. Premenopausal patients represent, to date, a small proportion of the population in a few trials, and the options for extending adjuvant ET, especially in those patients receiving ovarian function suppression (OFS), are underexplored yet. For post-menopausal women, numerous sequences and durations have been proposed, but the optimal duration of extended adjuvant ET remains controversial. Distinct aspects influence this choice, such as the patient’s menopausal status, risk of recurrence, toxicity profile and patient’s preference. Furthermore, the introduction of new targeted agents into the adjuvant setting has brought new uncertainty regarding the ideal length of ET.

(BELG J MED ONCOL 2024;18(4):124–31)