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Editorial
October 2018

PIK3CA Mutations in Hormone Receptor–Positive Breast Cancers: PIKing Biomarkers to Inform Adjuvant Endocrine Therapy Decisions

Author Affiliations
  • 1The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland
JAMA Oncol. 2018;4(10):1330-1332. doi:10.1001/jamaoncol.2018.1766

Adjuvant endocrine therapy is recommended to almost every woman with stage I to III breast cancer whose tumor expresses estrogen or progesterone receptors. Several strategies are available to women with early-stage, hormone receptor–positive breast cancer to improve disease-free survival (DFS) and overall survival, including tamoxifen for 5 to 10 years, aromatase inhibitors (AIs) for 5 to 10 years, or a sequential regimen of tamoxifen for 2 to 5 years followed by an AI for 3 or more years. Virtually every study that compared AI-based therapy with tamoxifen has demonstrated small DFS benefits to those receiving an AI.1-3 Therefore, the incorporation of an AI as part of their adjuvant endocrine therapy is recommended for postmenopausal women, and premenopausal women with high-risk, hormone receptor–positive tumors are considered for ovarian suppression with an AI.4-6

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