Surgeons are often the first physicians to
evaluate patients with newly diagnosed
breast cancer and, therefore, are critically
important in presenting and explaining the
option of neoadjuvant treatment to patients.
Neoadjuvant endocrine therapy can reduce
the extent of breast surgery and provide
information that may allow patients with
low-risk ER-positive tumors that achieve a
favorable PEPI score to avoid chemotherapy.
Despite the dramatic responses seen with
neoadjuvant endocrine therapy in Z1031, the
uptake of neoadjuvant endocrine therapy
in the U.S. has been slow. The Z1031 study
results were presented at the American
Society of Clinical Oncology annual meeting
in 2010 and were published in the Journal of
Clinical Oncology in 2011. In subsequent years,
use of neoadjuvant endocrine therapy in
patients with stage II–III ER-positive breast
cancer has slowly increased. However, the
overall use of neoadjuvant endocrine therapy
remains low, with 2. 4 percent of c T2-4c ER-positive breast cancer patients age ≥ 50 being
treated with neoadjuvant endocrine therapy.
Historically, it has been shown that it
can take 17 years for the results of a clinical
trial to impact clinical practice. Allowing
our patients the benefit of recent advances
in oncology is important to improve the
clinical care of our patients. Tailoring both
surgical and systemic treatment based
on the response to endocrine therapy in
patients with hormone receptor-positive
breast cancer allows us to take another step
forward in individualizing patient care. ♦
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ACS CLINICAL RESEARCH PROGRAM
Tailoring both surgical and systemic treatment based
on the response to endocrine therapy in patients with
hormone receptor-positive breast cancer allows us to take
another step forward in individualizing patient care.