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Practice Point
Initial adjuvant endocrine therapy – Men and premenopausal women
Offer tamoxifen as the initial adjuvant endocrine therapy for men and premenopausal women with ER-positive invasive breast cancer with low risk of recurrence.
Offer tamoxifen as the initial adjuvant endocrine therapy for men and premenopausal women with ER-positive invasive breast cancer.
Tamoxifen alone for 5 years is indicated for low-risk patients (Level of evidence – I)
Strong recommendation, high quality evidence. Strong recommendation, can apply to most patients in most circumstances without reservation
A “strong” rating was assigned when the observed consensus agreement was between 90% and 100%
How this guidance was developed
This recommendation was adapted from two source recommendations: a recommendation in the NICE 2018 guidelines (UK) based on a systematic review of the evidence conducted to September 2017 and used wording indicative of a strong recommendation (using GRADE methods) by the source guideline authors and a recommendation in the ESO-ESMO 2017 (Europe) guidelines for young women, and graded ’A’ (using ACCP methods). The recently released ASCO 2020 guideline on the management of male breast cancer is noted. This guideline, based on a systematic review of the evidence to 20 September 2019, indicates that ‘Men with hormone receptor–positive breast cancer who are candidates for adjuvant endocrine therapy should be offered tamoxifen’ (Type: formal consensus; Evidence quality: low; Strength of recommendation: strong).
Related guidance by topic
Initial adjuvant endocrine therapy – Men and premenopausal women
Practice Point
Offer tamoxifen as the initial adjuvant endocrine therapy for men and premenopausal women with ER-positive invasive breast cancer with low risk of recurrence.
Principles in action
Safe and quality care
This recommendation was adapted from two source recommendations: a recommendation in the NICE 2018 guidelines (UK) based on a systematic review of the evidence conducted to September 2017 and used wording indicative of a strong recommendation (using GRADE methods) by the source guideline authors and a recommendation in the ESO-ESMO 2017 (Europe) guidelines for young women, and graded ’A’ (using ACCP methods). The recently released ASCO 2020 guideline on the management of male breast cancer is noted. This guideline, based on a systematic review of the evidence to 20 September 2019, indicates that ‘Men with hormone receptor–positive breast cancer who are candidates for adjuvant endocrine therapy should be offered tamoxifen’ (Type: formal consensus; Evidence quality: low; Strength of recommendation: strong).
Related guidance by topic
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