Current Endocrine Therapy in Hormone-Receptor-Positive Breast Cancer - From Tumor Biology to the Rationale for Therapeutic Tunning

Sep 23, 2026

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Objective: evaluate current evidence for hormone treatments in premenopausal and postmenopausal women with early-stage hormone receptor (HR) positive breast cancer. Methods: an in-depth review of existing literature using landmark trials (TEXT, SOFT, ATLAS, aTTom) as key references. Results: low-risk premenopausal patients benefit from 5-year tamoxifen monotherapy; intermediate-to-high risk may require ovarian suppression plus an aromatase inhibitor/selective estrogen receptor modulator, potentially extending treatment. Postmenopausal low-risk patients usually receive 5-year aromatase inhibitors, while intermediate-to-high risk may need combination and/or extension. Conclusions: treatment consensus depends on menopausal status and recurrence risk.

LanguageEnglish

CategoryHealthcare

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Pages16

Reading Time40 min

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Abstract

Background and Objectives

Materials and Methods

Results

Conclusions

Keywords

1. Introduction

Review Current Endocrine Therapy in Hormone-Receptor-Positive Breast Cancer: From Tumor Biology to the Rationale for Therapeutic Tunning Oana Maria Burciu 1, Adrian-Grigore Merce 2, Simona Cerbu 3, Aida Iancu 4, Tudor-Alexandru Popoiu 5, Ionut Marcel Cobec 6,7, *, Ioan Sas 8,* and Gabriel Mihail Dimofte 9 Academic Editor: Miki Nakazawa-Miklasevica Received: 22 June 2025 Revised: 11 July 2025 Accepted: 14 July 2025 Published: 16 July 2025 Citation: Burciu, O.M.; Merce, A.-G.; Cerbu, S.; Iancu, A.; Popoiu, T.-A.; Cobec, I.M.; Sas, I.; Dimofte, G.M. Current Endocrine Therapy in Hormone-Receptor-Positive Breast Cancer: From Tumor Biology to the Rationale for Therapeutic Tunning. Medicina 2025, 61, 1280. [https://](https://)[ ](https://)[doi.org/10.3390/medicina61071280](doi.org/10.3390/medicina61071280) [Copyright:](Copyright:) © 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) . 1 Doctoral School, Faculty of Medicine,“Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania 2 Department of Cardiology, Institute of Cardiovascular Diseases, 300310 Timisoara, Romania 3 Discipline of Radiology and Medical Imaging,“Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania 4 Department of Radiology,“Victor Babes” University of Medicine and Pharmacy Timisoara, E. Murgu Square No. 2, 300041 Timisoara, Romania 5 Department of Functional Sciences, Medical Informatics and Biostatistics Discipline,“Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania 6 Clinic of Obstetrics and Gynecology, Klinikum Freudenstadt, 72250 Freudenstadt, Germany 7 ANAPATMOL Research Center, Faculty of Medicine,“Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania 8 Department of Obstetrics and Gynecology,“Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania 9 Department of Surgery, Regional Institute of Oncology Iasi, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700483 Iasi, Romania * Correspondence: [cobec_i@yahoo.com](cobec_i@yahoo.com) (I.M.C.); [sas.ioan@umft.ro](sas.ioan@umft.ro) (I.S.); Tel.: +40-722436147 (I.M.C.) Abstract Background and Objectives: The objective of this review is to evaluate the current evidence regarding hormone treatments for both premenopausal and postmenopausal women with early-stage hormone receptor (HR) positive breast cancer. Materials and Methods: An indepth exploration of the existing literature was conducted, with landmark clinical trials such as TEXT, SOFT, ATLAS, and aTTom serving as primary references. Results: Through an extensive review of the literature, our findings indicate that for premenopausal women with HR-positive, HER2-negative BC with a low risk of recurrence, standard 5-year monotherapy with tamoxifen represents the optimal therapeutic management, given its favorable clinical outcomes and lower associated toxicity. In contrast, for premenopausal women with an intermediate to high risk of recurrence with the same tumor characteristics, the most effective approach stated in the literature is a combination of ovarian suppression therapy (chemical/surgical) and an aromatase inhibitor/selective estrogen receptor modulator (tamoxifen), with a possible extension of the standard therapeutic period. In postmenopausal patients with HR-positive, HER2-negative breast cancer with a low recurrence risk, the first line of treatment is usually a standard 5-year period of treatment with aromatase inhibitors (AIs)(letrozole, anastrozole, or exemestane) . On the other hand, in postmen

FAQs

What is the review’s main objective regarding hormone therapy in HR-positive breast cancer?

To evaluate current evidence for hormone treatments in both premenopausal and postmenopausal women with early-stage HR-positive breast cancer.

Which landmark trials are used as primary references in the review?

TEXT, SOFT, ATLAS, and aTTom are cited as primary references.

How does the recommended therapy differ by menopausal status and recurrence risk?

Low-risk premenopausal patients are described as best managed with 5-year tamoxifen; intermediate-to-high risk may need ovarian suppression plus an aromatase inhibitor or SERMs, potentially extending therapy. Postmenopausal low-risk patients usually start with 5-year aromatase inhibitors, while intermediate-to-high risk may require combination therapy and/or extension.

Sep 23, 2026

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