Aromatase Inhibitors & DCIS Prophylaxis: Latest Research & Recommendations

Question
Hi, I was wondering if you could point me towards current evidence (i.e. studies) regarding aromatase inhibitor or SERM therapy as prophylaxis following ER+ DCIS treated with lumpectomy and tamoxifen, without radiation, specifically using hormonal therapy for more than five years. It is my understanding that recommendations for therapy was 5 years, but may be increasing now.

Thanks

Answer
Well, I would not myself treat a patient in that way. In my experience and according to all my training a lumpectomy SHOULD be followed by radiation therapy. I have yet not seen any convincing evidence against that attitude. If Tamoifen or an aromatase inhibitor also is used may be a matter of taste though probably the aromatase inhibitor is somewhat better. If the tumor was positive for hormonal receptors as in this case I would definitely also recommend aromatase inhibitor (or maybe Tamoxifene) treatment. But I would not abstain from radiation therapy or recommending it just because of that.



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