> 63 Tratamiento sistémico del cáncer de mama – Se deben considerar los efectos secundarios de cada una de las terapias endocrinas para seleccionar la más indicada en cada caso. Tener en cuenta la baja adherencia al tratamiento hormonal adyuvante. – Valorar de forma individualizada la prolongación de la terapia endocrina hasta 10 años según tolerancia al tratamiento y riesgo de recidiva. – El tamoxifeno se asocia con un incremento del riesgo de trombosis y de carcinoma de endometrio, por lo que está indicado el control con ecografía vaginal anual. – Las pacientes que vayan a recibir tratamiento con IA y castración ovárica deben ser advertidas del riesgo de osteoporosis, por lo que habrá que considerar la realización de densitometría ósea de forma periódica (bienal). LECTURAS RECOMENDADAS ASCO guidelines. Adjuvant Endocrine Therapy for Women With Hormone Receptor-Positive Breast Cancer. J Clin Oncol. 2019;5(10):423-38. Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2019. Gray R, Hughes LL, Wood WC, Lowen MA, Badve SS, et al. Extended aromatase inhibitor treatment following 5 or more years of endocrine therapy: A meta-analysis of 22,192 women in 11 randomized trials. SABCS. 2018; Abstract GS3-04. SEOM. Clinical Guidelines in early breast cancer (2018). Clin Transl Oncol. 2019;21(1):18-30. BIBLIOGRAFÍA 1. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;365:1687-717. 2. Breast Cancer NCCN Clinical Practice Guidelines in Oncology. Version 1.2019. March 14, 2019. 3. Davies C, Pan H, Godwin J, Gray R, Arriagada R, Raina V, et al. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet. 2013;9;381(9869):805-16. Erratum in: Lancet. 2013;9;381(9869):804. 4. Goss PE, Ingle JN, Martino S, Robert NJ, Muss HB, Piccart MJ, et al. A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N Engl J Med. 2003; 349:1793-802. 5. Pagani O, O’Neill A, Castiglione M, Gelber RD, Goldhirsch A, Rudenstam CM, et al. Prognostic impact of amenorrhoea after adjuvant chemotherapy in premenopausal breast cancer patients with axillary node involvement: results of the International Breast Cancer Study Group (IBCSG) Trial VI. Eur J Cancer. 1998;34:632-40. 6. Francis PA, Regan MM, Fleming GF, Láng I, Ciruelos E, Bellet M, et al. Adjuvant ovarian suppression in premenopausal breast cancer. N Engl J Med. 2015;372:436-46. 7. Francis PA, Pagani O, Fleming GF, Walley BA, Colleoni M, Láng I, et al. TailoringAdjuvant Endocrine Therapy for Premmenopausal Breast Cancer. N Engl J Med. 2018;12;379(2):122-37. 8. Bliss JM, Kilburn LS, Coleman RE, Forbes JF, Coates AS, Jones SE, et al. Disease-related outcomes with longterm follow-up: an updated analysis of the intergroup exemestane study. J Clin Oncol. 2012;30:709-17.
RkJQdWJsaXNoZXIy MTQzMjMwMg==