[Adjuvant endocrine forms of therapy in breast cancer]

Determination of oestrogen receptor (ER) and progesterone receptor (PgR) allows a prediction of response to endocrine treatment in patients with metastasizing breast cancer. Randomized trials of ovariectomy or irradiation of the ovaries showed a prolonged recurrence-free interval in these patients as compared with a non-castrated control group, but no influence on the overall survival rate. All these studies were performed without prior knowledge of the ER and PgR status of the primary tumour. Randomized trials with the anti-oestrogen, tamoxifen showed a prolonged recurrence-free interval; one study showed significantly prolonged overall survival. Studies employing combined chemo-hormonal therapy showed a lower recurrence rate in postmenopausal patients with ER + PgR + tumours, as compared with patients treated by chemotherapy alone. Adjuvant treatment prolongs the recurrence-free interval in postmenopausal patients. The follow-up periods are too short as yet to allow final conclusions regarding influence on the overall survival rate to be drawn. An optimal adjuvant endocrine treatment schedule in premenopausal patients with ER + PgR + tumours needs to be established in future studies.