BACKGROUND: Many studies about the adjuvant endocrine therapy of postmenopausal patients with hormone receptor-positive breast cancer have shown significant superiority of aromatase inhibitors (AIs) compared to tamoxifen only. Within these studies, different AIs (anastrozole, letrozole, exemestane) and treatment strategies (upfront, switch, extended adjuvant) were applied. MATERIAL AND METHODS: The intention of our enquiry was to evaluate the implementation of the results of these studies in German breast cancer centers and university hospitals. Questionnaires were sent to 200 breast cancer centers and university hospitals (returns: 108). RESULTS: Our enquiry showed that most centers preferred anastrozole as upfront therapy in patients with an intermediate or high risk of relapse. Furthermore, during AI therapy, additional bisphosphonate treatment was applied 'always' in only 9% of cases, and in 78% of cases of proved osteopenia/osteoporosis. Surprisingly, 50% of the participating centers do not exclude AIs in premenopausal women. CONCLUSION: At the time of our enquiry, anastrozole as upfront therapy was consistent with the recommendations of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) from 2009. Compared to tamoxifen, AIs increase the risk of osteoporosis, which can, however, be prevented and treated with concomitant bisphosphonate therapy. The rare use of bisphosphonates as well as contraindicated AI therapy in premenopausal patients show amongst others the substantial need for more information.
BACKGROUND: Many studies about the adjuvant endocrine therapy of postmenopausal patients with hormone receptor-positive breast cancer have shown significant superiority of aromatase inhibitors (AIs) compared to tamoxifen only. Within these studies, different AIs (anastrozole, letrozole, exemestane) and treatment strategies (upfront, switch, extended adjuvant) were applied. MATERIAL AND METHODS: The intention of our enquiry was to evaluate the implementation of the results of these studies in German breast cancer centers and university hospitals. Questionnaires were sent to 200 breast cancer centers and university hospitals (returns: 108). RESULTS: Our enquiry showed that most centers preferred anastrozole as upfront therapy in patients with an intermediate or high risk of relapse. Furthermore, during AI therapy, additional bisphosphonate treatment was applied 'always' in only 9% of cases, and in 78% of cases of proved osteopenia/osteoporosis. Surprisingly, 50% of the participating centers do not exclude AIs in premenopausal women. CONCLUSION: At the time of our enquiry, anastrozole as upfront therapy was consistent with the recommendations of the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) from 2009. Compared to tamoxifen, AIs increase the risk of osteoporosis, which can, however, be prevented and treated with concomitant bisphosphonate therapy. The rare use of bisphosphonates as well as contraindicated AI therapy in premenopausal patients show amongst others the substantial need for more information.
Authors: Raimund Jakesz; Walter Jonat; Michael Gnant; Martina Mittlboeck; Richard Greil; Christoph Tausch; Joern Hilfrich; Werner Kwasny; Christian Menzel; Hellmut Samonigg; Michael Seifert; Guenther Gademann; Manfred Kaufmann; Johann Wolfgang Journal: Lancet Date: 2005 Aug 6-12 Impact factor: 79.321
Authors: Michael Gnant; Brigitte Mlineritsch; Herbert Stoeger; Gero Luschin-Ebengreuth; Dietmar Heck; Christian Menzel; Raimund Jakesz; Michael Seifert; Michael Hubalek; Gunda Pristauz; Thomas Bauernhofer; Holger Eidtmann; Wolfgang Eiermann; Guenther Steger; Werner Kwasny; Peter Dubsky; Gerhard Hochreiner; Ernst-Pius Forsthuber; Christian Fesl; Richard Greil Journal: Lancet Oncol Date: 2011-06-05 Impact factor: 41.316
Authors: L Mauriac; A Keshaviah; M Debled; H Mouridsen; J F Forbes; B Thürlimann; R Paridaens; A Monnier; I Láng; A Wardley; J-M Nogaret; R D Gelber; M Castiglione-Gertsch; K N Price; A S Coates; I Smith; G Viale; M Rabaglio; N Zabaznyi; A Goldhirsch Journal: Ann Oncol Date: 2007-02-14 Impact factor: 32.976
Authors: R C Coombes; L S Kilburn; C F Snowdon; R Paridaens; R E Coleman; S E Jones; J Jassem; C J H Van de Velde; T Delozier; I Alvarez; L Del Mastro; O Ortmann; K Diedrich; A S Coates; E Bajetta; S B Holmberg; D Dodwell; E Mickiewicz; J Andersen; P E Lønning; G Cocconi; J Forbes; M Castiglione; N Stuart; A Stewart; L J Fallowfield; G Bertelli; E Hall; R G Bogle; M Carpentieri; E Colajori; M Subar; E Ireland; J M Bliss Journal: Lancet Date: 2007-02-17 Impact factor: 79.321
Authors: John F Forbes; Jack Cuzick; Aman Buzdar; Anthony Howell; Jeffrey S Tobias; Michael Baum Journal: Lancet Oncol Date: 2008-01 Impact factor: 41.316
Authors: Eric P Winer; Clifford Hudis; Harold J Burstein; Antonio C Wolff; Kathleen I Pritchard; James N Ingle; Rowan T Chlebowski; Richard Gelber; Stephan B Edge; Julie Gralow; Melody A Cobleigh; Eleftherios P Mamounas; Lori J Goldstein; Timothy J Whelan; Trevor J Powles; John Bryant; Cheryl Perkins; Judy Perotti; Susan Braun; Amy S Langer; George P Browman; Mark R Somerfield Journal: J Clin Oncol Date: 2004-11-15 Impact factor: 44.544
Authors: Jack Cuzick; Ivana Sestak; Michael Baum; Aman Buzdar; Anthony Howell; Mitch Dowsett; John F Forbes Journal: Lancet Oncol Date: 2010-11-17 Impact factor: 41.316