HORMONO+

 For several decades, adjuvant endocrine therapy (AET) taken for a period of 5 years has been part of the standard of care for the management of early-stage, hormone-sensitive breast cancer. For approximately one third of patients (more advanced stage or extensive nodal involvement), extending AET is now recommended for a total duration of 7 to 10 years in order to reduce the risks of recurrence and death. However, the optimal duration of AET remains uncertain. According to a recent review, extending aromatase inhibitor therapy beyond 7 years provides only a marginal benefit in terms of disease-free survival and overall survival rates. A meta-analysis shows that extending aromatase inhibitors beyond 5 years, while offering significant advantages in terms of disease-free survival, does not significantly improve overall survival. 

Moreover, prolonged use of AET may, depending on the treatment taken, be associated with an increased risk of endometrial cancer and thromboembolic disease in the case of tamoxifen, and an increased risk of cardiotoxicity, osteoporotic fractures, and osteoporosis in the case of aromatase inhibitors. These major adverse effects add to the numerous effects recorded during the first 5 years of AET, which affect the quality of life of many patients and are the leading cause of non-adherence to treatment. In this context, the decision to extend AET beyond 5 years must weigh the absolute benefits against the additional potential risks and the adverse effects affecting women's quality of life