Neoadjuvant
endocrine therapy of locally advanced breast cancer
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In
our clinical practice, even outside trials, we are comfortable and
happy to treat patients with an estrogen receptor-rich, locally
advanced, indolent or large operable breast cancer by neoadjuvant
endocrine therapy, because we know the patients won’t come
to harm if we treat them for three months. And we know that they
can gain considerable potential benefits from three months of the
treatment. And we know that if within those three months they do
not respond, then we can do surgery as we were going to do previously.
If in that three months they respond but in that three months they
are suitable for lesser surgery, we'll just go ahead and do the
surgery then. In some of the patients you get a significant response
in three months but the tumor is very large so you might continue
for six months. And we tend not to continue for much longer than
six months because of the studies which you have looked at giving
tamoxifen to elderly patients, long-term, the tumors definitely
grow out of control if you just leave them on tamoxifen alone.
Primary
chemotherapy or hormonotherapy for patients with breast cancer.
[Review] Brain EG. Misset JL. Rouess J. Cancer Treatment Reviews. 25(4):187-97,
1999.
