The major role of endocrine therapy in the treatment of early and advanced breast cancer should not be forgotten as an increasing number of new and potentially more exciting agents are introduced. Endocrine therapy generally has a more powerful effect than cytotoxic therapy in the treatment of breast cancer. Alternatives to tamoxifen, such as anastrozole (Arimidex®), are now being considered, both in advanced disease and as adjuvant therapy, whether as single agents or in combination. Anastrozole has a low side-effect profile and is becoming a drug of choice for second-line therapy in postmenopausal women with advanced breast cancer. The present use of anastrozole in postmenopausal women with advanced breast cancer includes second-line treatment after tamoxifen and first-line treatment after tamoxifen has been used as an adjuvant treatment. It may also be used when tamoxifen is not tolerated. The future potential of anastrozole is currently being investigated in a programme of clinical trials in postmenopausal women, including first-line treatment of advanced disease and as an adjuvant treatment for early breast cancer.
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