Neoadjuvant hormonal therapy in breast cancer

Abstract

The various types of ER-positive and HER-2-negative breast cancers have different treatment modalities. There are two options for the treatment of locally advanced breast cancer: chemotherapy or hormonal therapy. Chemotherapy can be particularly toxic for elderly postmenopausal patients, and neoadjuvant hormonal therapy (NHT) is an alternative for patients with hormone receptor-positive, locally advanced, postmenopausal breast cancer. This treatment is also highly beneficial for patients with comorbidities and can comprise tamoxifen and steroidal or nonsteroidal aromatase inhibitors (AIs). The best activities in clinical trials are observed with AIs. NHT produces good response rates (RRs) as well as adequate downstaging of tumor size such that breast-conserving surgery (BCS) may become an option. The optimal duration of such treatments should not be less than 4 months and may be continued for as long as 8 months.