PIK 3CA Mutations in Hormone Receptor–Positive Breast Cancers

Adjuvant endocrine therapy is recommended to almost every woman with stage I to III breast cancer whose tumor expresses estrogen or progesterone receptors. Several strategies are available to women with early-stage, hormone receptor–positive breast cancer to improve disease-free survival (DFS) and overall survival, including tamoxifen for 5 to 10 years, aromatase inhibitors (AIs) for 5 to 10 years, or a sequential regimen of tamoxifen for 2 to 5 years followed by an AI for 3 or more years. Virtually every study that compared AI-based therapy with tamoxifen has demonstrated small DFS benefits to those receiving an AI. Therefore, the incorporation of an AI as part of their adjuvant endocrine therapy is recommended for postmenopausal women, and premenopausal women with high-risk, hormone receptor–positive tumors are considered for ovarian suppression with an AI.

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