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Treatment approach to metastatic hormone receptor-positive breast cancer: Endocrine therapy

Authors
Michael J Naughton, MD
Cynthia X Ma, MD, PhD
Section Editor
Daniel F Hayes, MD
Deputy Editor
Sadhna R Vora, MD

INTRODUCTION

Although metastatic breast cancer is unlikely to be cured, there have been meaningful improvements in survival due to the availability of more effective systemic therapies [1-4].

Beatson's historic observations on the regression of breast cancer following oophorectomy over 100 years ago provided the first insight into the estrogen-dependent nature of breast cancer [5]. With the recognition that estrogen has an important role in the promotion and progression of hormone receptor-positive breast cancer, endocrine therapy is a principle component in the treatment of hormone-sensitive breast cancer in the adjuvant and metastatic settings.

The endocrine treatment of breast cancer utilizes strategies that reduce or halt estrogen production, block signaling through the estrogen receptor (ER), or antagonize ER itself. For women with intact ovarian function, this would also include targeting the ovaries directly by inducing temporary (ie, ovarian suppression) or permanent (ovarian ablation) menopause.

Endocrine therapy for metastatic breast cancer is presented here. The use of chemotherapy with or without human epidermal growth factor receptor 2 (HER2)-directed therapy for metastatic breast cancer and the approach to breast cancer in men are discussed separately.

(See "Systemic treatment for metastatic breast cancer: General principles".)

                                                 

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Literature review current through: Nov 2016. | This topic last updated: Thu Nov 17 00:00:00 GMT+00:00 2016.
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