Guidelines from ASCO

The American Society of Clinical Oncologists (ASCO) makes recommendations about hormonal therapy in various situations. They updated these detailed guidelines in December 2004. The guidelines are based on results from clinical trials as well as on uses approved by the FDA.

ASCO guidelines for women with early-stage disease

• Consider taking an aromatase inhibitor:
  • if you are post-menopausal and have hormone-receptor-positive breast cancer.
  • as a first-choice hormonal treatment (Arimidex or Femara).
  • after two to three years of tamoxifen (Arimidex or Aromasin).
  • after five years of tamoxifen (Femara).
  • before surgery, to shrink tumors larger than two centimeters.
  • if you are at high risk for breast cancer but have no personal history of the disease.

Aromatase inhibitors should be taken for five years. Aromatase inhibitors are not taken for more than five years unless you are part of a clinical trial to test their effectiveness.

• Consider taking tamoxifen:
  • if you are pre-menopausal and have hormone-receptor-positive breast cancer.
  • if you are post-menopausal and have trouble with the side effects of aromatase inhibitors.
  • if you have DCIS (ductal carcinoma in situ).
  • before surgery, to shrink tumors larger than two centimeters.
  • if you are at high risk for breast cancer but have no personal history of the disease.

Tamoxifen should be taken for five years. Tamoxifen is not taken for more than five years unless you are part of a clinical trial to test its effectiveness.

ASCO guidelines for women with advanced (metastatic) disease

• Consider taking any aromatase inhibitor:
  • if you've completed two to five years of tamoxifen.
  • if the cancer has grown or spread while you were taking tamoxifen.
• Consider taking Faslodex, an estrogen-receptor downregulator (ERD):
  • if the cancer has grown or spread while you were taking an aromatase inhibitor or tamoxifen.