What are the ASCO guidelines for the use of hormonal adjuvant therapy in the treatment of premenopausal women with breast cancer?

Updated: Dec 27, 2019
  • Author: Pavani Chalasani, MD, MPH; Chief Editor: John V Kiluk, MD, FACS  more...
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Answer

In 2016, the American Society of Clinical Oncology (ASCO) issued an updated clinical practice guideline on adjuvant endocrine therapy for premenopausal women with hormone receptor–positive breast cancer.  ASCO recommends high-risk women receive adjuvant endocrine therapy with ovarian suppression but lower-risk patients should not. [192]

Specific recommendations include  [192]

  • Women with stage II or stage III breast cancers who would ordinarily be advised to receive adjuvant chemotherapy should receive ovarian suppression in addition to endocrine therapy

  • Women with stage I or II breast cancers at higher risk of recurrence, who might consider chemotherapy, may also be offered ovarian suppression in addition to endocrine therapy

  • Women with stage I breast cancers not warranting chemotherapy should receive endocrine therapy but not receive ovarian suppression

  • Women with node-negative cancers 1 cm or less (T1a, T1b) should receive endocrine therapy but not receive ovarian suppression

  • Ovarian suppression may be administered with either tamoxifen or an aromatase inhibitor

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