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March 2, 2005

Adjuvant Therapy of Breast Cancer in the ElderlyDoes One Size Fit All?

Author Affiliations

Author Affiliations: Department of Medicine, Division of Hematology/Oncology, Feinberg School of Medicine, and Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Ill.

JAMA. 2005;293(9):1118-1120. doi:10.1001/jama.293.9.1118

The impact of adjuvant therapy for treatment of early stage breast cancer has clearly reduced the risk of disease recurrence and breast cancer mortality. The evolution of adjuvant therapy for treatment of early stage breast cancer is a story of incrementalism, built on the solid observation made more 3 decades ago that administration of postoperative chemotherapy improves outcome for patients with breast cancer.1 Numerous large randomized clinical trials have subsequently reaffirmed that early observation.2 With the characterization of the estrogen receptor (ER) and the introduction of tamoxifen, adjuvant endocrine therapy proved to be highly effective as another, although not mutually exclusive, systemic approach for treatment of patients with tumors expressing ER. Additionally, the benefit of tamoxifen conferred to patients with tumors expressing ER is fairly similar across age groups.2 More recently, the introduction of selective aromatase inhibitors as adjuvant endocrine therapy in postmenopausal women appears to have incrementally improved outcome compared with tamoxifen alone.37

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