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Other Guidelines
Guidelines on endocrine therapy of breast cancer
1. Selection of suitable cases for adjuvant endocrine
therapy
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Rationale
As discussed above, there is convincing evidence that the benefit in lowering
the risk of disease recurrence with adjuvant endocrine therapies is related to
the steroid hormone receptor content of the primary tumour. In patients whose
primary tumour is classified as receptor negative the benefit with adjuvant
endocrine therapy is unlikely to be clinically meaningful
[1][2].
In addition, since the reduction in mortality is constant
[1][2],
patients with a low risk of recurrence derive little benefit from adjuvant
endocrine therapy.
The potential of adjuvant endocrine therapy to prevent or delay the appearance
of a contralateral primary breast cancer is not in itself sufficient as an
indication for routine treatment, given that the prognosis is usually dictated
by thefirst tumour, the risk of adverse side-effects and uncertainty as to the
effect on overall survival.
| Quality objective |
Outcome measure
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To obtain adequate information for the allocation of systemic treatment |
To obtain (in addition to hormone receptor status) histopathological
lymph node status, tumour size and tumour grade in all operable cases of
early-stage breast cancer and to integrate these to estimate the prognosis e.g.
by the Nottingham Prognostic Index (see below) or by using the St. Gallen
Consensus Guidelines
[3].
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