Endocrine therapy for breast cancer patients

  For adjuvant endocrine therapy in premenopausal breast cancer patients, patients may choose to undergo either excisional debulking or functional suppression of the ovaries with or without TAM for 2-3 years as a basic option. (1) If patients enter menopause, they may choose to continue to complete 5 years of TAM therapy on the one hand and receive 5 years of trimethoprim therapy thereafter; on the other hand, they may also consider switching to exemestane or anastrozole to complete 5 years of adjuvant endocrine therapy. (2) If the patient is still in premenopausal status, he/she should complete 5 years of TAM treatment. after 5 years of TAM adjuvant endocrine therapy, if the patient enters menopause, he/she can receive another 5 years of trimethoprim therapy; if he/she is still in premenopause, he/she does not need to continue endocrine therapy.  For postmenopausal breast cancer patients, (1) 5 years of anastrozole or letrozole can be one of the options; (2) 2-3 years of TAM treatment, during which time the patient switches to exemestane or anastrozole to complete 5 years of endocrine therapy; (3) 4.5-6 years of TAM followed by 5 years of letrozole; (4) when the patient is accompanied by contraindications to AIs, or the patient subjectively refuses to receive AIs, or the patient cannot tolerate the toxic effects of AIs, TAM for 5 years should be the standard choice.