Teamwork makes the antiestrogen dream work.

July 20, 2017. Endocrine therapy (ET) has long been established as the standard of care for any healthy woman with localized, hormone-receptor positive breast CA. So how well are we maintaining standards? Better every day it seems. A huge cohort study reported in JAMA Onc this month assessed trends in the use of ET over the past decade (2004 → 2013). For the >800K women with hormone-receptor positive Stage I-III breast cancers analyzed, the (appropriate) use of ET increased from 70% → 82%. Of all demographic and treatment variables assessed, the receipt of ET was most positively associated with the receipt of RT following surgery...which the authors view as a potential surrogate for multidisciplinary care. Why does this matter? The 2011 EBCTCG meta-analysis showed that Tamoxifen reduces breast CA mortality by one third. Data which was supported by a 29% relative reduction in mortality with the use of ET noted in this report. In other words, the appropriate use of ET could have saved an additional 14,630 lives over the decade of interest. Numbers worth remembering next time you consider ditching multi-D tumor board.