What does endocrine therapy for breast cancer mean?

  Endocrine therapy has been reported as early as 1896 for the treatment of advanced and recurrent breast cancer, and the discovery of estrogen receptor (ER) in the 1970s. Those with low ER content are called hormone-non-dependent tumors, and these cases are poorly treated with endocrine therapy. Therefore, in addition to pathological examination of surgically resected specimens, estrogen receptors and progesterone receptors (PgR) should be measured. This can help in the selection of adjuvant treatment options, with priority application of endocrine therapy in hormone receptor-positive cases. Chemotherapy is given priority in receptor-negative cases. It also has a role in determining prognosis.  An important development in endocrine therapy in recent years is the application of triamcinolone acetonide. Triamcinolone is a non-steroidal hormone anti-estrogen drug with a structural formula similar to that of estrogen, which can compete with estradiol for ER in target organs, and the triamcinolone and ER complex can affect DNA gene transcription, thus inhibiting tumor cell growth. Clinical application shows that this drug can reduce postoperative recurrence and metastasis of breast cancer, especially in postmenopausal women with positive ER and PgR. It also reduces the incidence of contralateral breast cancer. The dosage of triamcinolone acetonide is 20 mg per day for at least 3 years and is usually taken for 5 years. Taking the drug for more than 5 years, or at doses greater than 20 mg per day, has not proven to be more effective. The drug is safe and effective. Side effects include hot flashes, nausea, vomiting, venous thrombosis, eye side effects, and vaginal dryness or excessive discharge. The possibility of endometrial cancer in a few cases after long-term application has been a concern, but the incidence of the latter is low and the prognosis is good. Therefore, the adjuvant application of triamcinolone acetonide after breast cancer surgery is more beneficial than harmful.  The newly developed aromatase inhibitors such as Letrova have been shown to be more effective than triamcinolone. These drugs can inhibit the aromatization link in the process of conversion of androgens secreted by adrenal glands into estrogens, thus reducing estradiol and achieving the purpose of treating breast cancer.