Notes of endocrine therapy in breast cancer

Surgery, chemotherapy, and radiation therapy are common breast cancer treatments, however, endocrine therapy is known to be a targeted treatment in breast cancer, being gentle and effective in patients with hormone receptor-positive breast cancer.

Video content is professionally consulted by MSc Nong Ngoc Son, Head of Oncology Department, Vinmec Central Park International General Hospital

Hormones are substances secreted by one or more cells in the body that function as "messages" in the body. They send signals from cells and organs to other tissues and organs through the bloodstream to perform functions at that receptor. Estrogen and progesterone are hormones produced by the ovaries in postmenopausal women and some other tissues including fat and skin in postmenopausal women and men. These two hormones help maintain female characteristics and bone growth. In addition, it stimulates the formation and growth of certain types of breast cancer, also known as hormone-sensitive breast cancer.
Hormone therapy (also called hormone therapy, hormone therapy, or endocrine therapy) is a treatment that aims to slow or stop the growth of hormone-sensitive tumours. by blocking the body's ability to produce hormones or by interfering with hormone action. Tumors that are not hormone sensitive do not respond to hormone therapy. Hormone therapy for breast cancer is not the same as menopausal hormone therapy or female hormone therapy, in that hormones are given to relieve symptoms of menopause.
Doctors will evaluate your tumor with a biopsy or do tests after it is removed by surgery. Tumors are considered sensitive to endocrine therapy when on the surface of cancer cells there are estrogen receptors (ER (i a) positive) or progesterone receptors (progesterone receptors) (PR positive - pi). a is positive).

There are many endocrine therapies for hormone sensitive breast cancers such as:
Ovarian suppression: the ovaries are the main site of estrogen production in postmenopausal women. Therefore, inhibiting ovarian function helps to reduce the amount of hormones in the body, thereby preventing the growth of breast tumors. There are many methods of ovarian suppression, such as surgical or radiological removal of the ovaries or with GnRH agonists (gonadotropin-releasing hormone). These agonists block signals from the hypothalamus to stimulate the ovaries to produce estrogen. Reduces estrogen production: Drugs that inhibit aromatase – an enzyme that helps make estrogen from other tissues in the body. These drugs are often used in postmenopausal patients because the patient's ovaries no longer produce estrogen but produce large amounts of aromatase, thereby increasing the response to the drug. However, aromatase inhibitors can also be used in premenopausal women if they are taking other measures to suppress the ovaries.

Selective estrogen receptor modulators, which competitively bind to estrogen receptors, block the effects of the hormone estrogen on cells.
Other drugs: such as fulvestrant, reduce the effect of estrogen by a different mechanism.
Endocrine therapy is usually indicated in the following cases:
Adjuvant treatment for early breast cancer: Using endocrine drugs for at least 5 years for patients with receptor-positive breast cancer Endocrine-positive early stage surgery reduces the risk of breast cancer recurrence Treatment of advanced or metastatic breast cancer Neoadjuvant treatment of breast cancer: the aim is to reduce tumor size , creating favorable conditions for radical mastectomy or breast-conserving surgery When treating breast cancer with endocrine therapy, patients will experience some unwanted side effects such as:
Hot flashes Night sweats Vaginal dryness Menstrual cycle disturbances in premenopausal patients Tamoxifen use increases the risk of blood clots, increases the risk of endometrial cancer or osteoporosis. Avoid using tamoxifen together with anticoagulants
The above are the notes of endocrine therapy in breast cancer, patients can refer to it. Learn more about the treatment.