Early recurrence risk: Aromatase inhibitors versus tamoxifen

Emilio Bria, Paolo Carlini, Federica Cuppone, Vanja Vaccaro, Michele Milella, Francesco Cognetti

Research output: Contribution to journalArticlepeer-review


Aromatase inhibitors (AIs) are becoming the hormonal treatment of choice for postmenopausal women with early breast cancer. Large, well-controlled clinical studies have established the efficacy and safety of initial adjuvant therapy with letrozole or anastrozole versus the previous standard of 5 years of adjuvant tamoxifen and support using an AI (exemestane, anastrozole or letrozole) following tamoxifen for 2-3 years (early 'switch treatment) or 5 years (extended adjuvant treatment). Reducing recurrence risk is a primary goal of adjuvant hormonal therapy. There is an early peak of recurrences 2 years after surgery; most are distant metastases rather than local or regional events. Therefore, treatment strategies such as initial therapy with AIs, which reduce early distant recurrence events, can be expected to improve long-term survival outcomes. Switching to an AI following 2-3 years of initial adjuvant tamoxifen is an effective option for patients unable to begin treatment with an AI.

Original languageEnglish
Pages (from-to)1239-1253
Number of pages15
JournalExpert Review of Anticancer Therapy
Issue number8
Publication statusPublished - Aug 2010


  • anastrozole
  • aromatase inhibitor
  • distant metastases
  • early breast cancer
  • exemestane
  • letrozole

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Oncology


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