Extended endocrine therapy for the treatment and prevention of breast cancer relapse

Antonio Llombart, MD, PhD, of the University Hospital Arnau de Vilanova, Valencia, Spain, discusses extended endocrine therapy for the prevention of relapse of breast cancer at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. He explains that an important debate amongst doctors has concerned the extended endocrine treatment for more than 5 years. The standard treatment of endocrine therapy was 5 years. However, new trials have shown that expanding treatment for more than 5 years could increase or could prevent late relapses. The debate is about which patients are good candidates for this treatment and which patients do not need more endocrine therapy after 5 years as there is a problem of toxicity of the treatment and ultimately a decreased quality of life. Dr Llombart believes that all patient should be informed about this fact and when patients achieve this 5-year treatment, even if they are not considered as good candidates because of the risks, they should still be informed of extended therapy as it is also a negotiation. The patient may be comfortable with the treatment with no toxicity effects and even if the risk of relapse is low, there are still benefits from extended endocrine therapy. He concludes by explaining that it is therefore not just the decision of the doctor but a combination of the doctor and the patient who will accept the continuation of treatment.

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