Table 1. Recommended Pharmaceuticals for HR+ Breast
Cancer
Agent Dose Comments
Antiestrogen
Tamoxifen 20–40 mg Boxed Warning :
• Uterine malignancies
• Stroke
• Pulmonary embolism
Aromatase Inhibitor
Anastrozole 1 mg PO qd Contraindications:
• Women of premenopausal endocrine
status, including pregnant women
• Known hypersensitivity
Exemestane 25 mg PO qd aer
a meal
Contraindications:
• Known hypersensitivity
Letrozole 2.5 mg PO qd Contraindications:
• Women of premenopausal endocrine
status, including pregnant women
Table 2. Prognostic Factors for Recurrence After 5 Years of
Adjuvant Endocrine Therapy
Factors Relationships
Anatomic Stage Nodal Status
Tumor Size
N+ > N–
Risk increase with increased T
Tumor Patholog y Higher grade
Lower levels of ER expression
Higher grade > lower grade
Higher ER < lower ER
Genomic assays Intrinsic subtype
21-gene recurrence score
PAM 50 ROR Score
Breast Cancer Index Score
EndoPredict Clinical Score
Luminal A < B
Lower < Higher
Lower < Higher
Lower < Higher
Lower < Higher
