Advances in adjuvant hormonal therapy for postmenopausal women.

INTRODUCTION Since George Beatson and A. Schinzinger produced remissions of advanced breast cancer by performing bilateral oophorectomy in premenopausal patients more than 100 years ago, the effect of antihormonal therapy on breast cancer has been known. Initial endocrine therapy included oophorectomy, hypophysectomy, and adrenalectomy. The latter two were abandoned when tamoxifen citrate was approved by the US Food and Drug Administration for use in advanced breast cancer in 1978. Selective estrogen receptormodulators (SERMs), such as tamoxifen, antagonize estrogen receptor (ER) function by binding competitively to it. Since 1978, more than 40,000 breast cancer patients, most of them postmenopausal, have been treated with tamoxifen, either in the context of clinical research studies or in clinical practice.