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Primary Endocrine Therapy

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Management of Breast Cancer in Older Women

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Abstract

Use of endocrine therapy alone for the treatment of operable breast cancer, (primary endocrine therapy or PET) was first described in the 1980s and is a strategy adopted to varying degrees by different countries. It is a good option for the very frail or unfit older women with ER positive breast cancer. Selection for its use must take into account the probable life expectancy of the woman because secondary antioestrogen resistance develops after a median of 2–3 years. The biology of the tumour has a strong influence on response rates and aromatase inhibitors perform better than tamoxifen in this setting. Primary endocrine therapy is well tolerated and may avoid unnecessary morbidity for some women if selected appropriately. At present there are no evidence based selection guidelines but it is hoped these will be published soon once the Age Gap trial reports.

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Authors and Affiliations

  1. Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK

    Jenna Morgan & Lynda Wyld

  2. Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK

    Lynda Wyld

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  1. Brighton and Sussex Medical School, Brighton, UK

    Malcolm Reed

  2. Department of Surgery, Sahlgrenska University Hospital, Institute of Clinical Sciences, Gothenburg, Sweden

    Riccardo A. Audisio

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Morgan, J., Wyld, L. (2019). Primary Endocrine Therapy. In: Reed, M., Audisio, R. (eds) Management of Breast Cancer in Older Women. Springer, Cham. https://doi.org/10.1007/978-3-030-11875-4_5

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