Dr. Mamounas on the Role of Extended Adjuvant Endocrine Therapy in ER+ Breast Cancer

Eleftherios (Terry) P. Mamounas, MD, MPH, FACS, medical director of the Comprehensive Breast Program at the University of Florida Health Cancer Center, discusses the role of extended adjuvant endocrine receptor (ER)–positive breast cancer.

According to Mamounas, extended endocrine therapy has demonstrated significant improvement in disease-free survival (DFS) and distant DFS. However, aside from adjuvant tamoxifen, most trials evaluating aromatase inhibitors (AIs) have not shown an improvement in overall survival.

Additionally, extended duration of adjuvant endocrine therapies is associated with significant toxicity, Mamounas explains.

Tamoxifen and AIs can cause arthralgias and myalgias, Mamounas adds. Moreover, adverse effects, such as decreased bone mineral density, thromboembolic or arterial thrombotic events, osteoporotic fracturs, and fatigue can occur.