Drug treatment recommendation for breast cancer in post-menopausal women

The American Society of Clinical Oncology has updated drug treatment guidelines for breast cancer in post-menopausal women.  An update to their guidelines on adjuvant endocrine therapy again supported the aromatase inhibitors for no more than five years, saying they provide better disease-free survival than tamoxifen (Nolvadex) in this patient population.  Still not resolved is the best strategy for using these drugs:  either upfront as monotherapy or sequentially after two to three years of tamoxifen. If sequential therapy is the strategy used, the available evidence supports an aromatase inhibitor after two or three years of tamoxifen for a total of five years of adjuvant endocrine therapy.  If patients discontinue initial aromatase inhibitor use before the full five years, tamoxifen can be considered for the the remainder of the five years.  The recommendation only applies to post-menopausal women.