[Hormone treatment of patients with breast carcinoma]

Endocrine treatments of breast cancer patients play an important role in the management of this common tumor of women. In this short review the most frequently applied drugs are discussed; thereafter, their use is shown in the curative (adjuvant) and in the palliative situation. In premenopausal women who suffer from a hormone-sensitive cancer, adjuvant treatments include either ovarian ablation or adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-fluoro-uracil. In post-menopausal women, the adjuvant treatment of choice is tamoxifen. The currently active protocols for adjuvant treatments of hormone-sensitive breast cancers of the International Breast Cancer Study Group (IBCSG) and the Swiss Group for Clinical Cancer Research (SAKK) should not be followed because of the anthracyclines administered to a high percentage of the involved patients. These drugs, known for their cardiotoxic side effects, have for the time being no place in the adjuvant treatment of hormone-sensitive breast cancers; therefore, the duty of the primary-care physician is to protect his patients from these protocols. In the palliative treatment, tamoxifen is the first choice. The success of this treatment is shown by a few examples.