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Breast Cancer.
Endocrine Therapy.

Dr. Marc Lippman
ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ. ืžื•ืžื—ื” ืœื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ืงื•ืจื•ืช ื—ื™ื™ื. 0
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1. ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ. ืžื•ืžื—ื” ืœื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ืงื•ืจื•ืช ื—ื™ื™ื. 0

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ืืช ื”ืชืคืชื—ื•ืช ื”ื˜ื™ืคื•ืœ ื”ืื ื“ื•ืงืจื™ื ื™. ื”ื•ื ืคืจื•ืคืกื•ืจ ืœืื•ื ืงื•ืœื•ื’ื™ื” ื•ืจืคื•ืื” ื‘ืื•ื ื™ื‘ืจืกื™ื˜ืช ื’'ื•ืจื’'ื˜ืื•ืŸ. ื“"ืจ ืœื™ืคืžืŸ ืžื•ืกืžืš ืžื˜ืขื...

ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื”ื™ืกื˜ื•ืจื™ื” ื•ื”ืชืงื“ืžื•ื™ื•ืช. 1
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2. ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื”ื™ืกื˜ื•ืจื™ื” ื•ื”ืชืงื“ืžื•ื™ื•ืช. 1

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ืืช ื”ื”ื™ืกื˜ื•ืจื™ื” ื•ื”ืžืฆื‘ ื”ื ื•ื›ื—ื™ ืฉืœ ื˜ื™ืคื•ืœื™ื ืื ื“ื•ืงืจื™ื ื™ื™ื. ื”ื•ื ืžืคืจื˜ ื›ื™ืฆื“ ืกืจื˜ืŸ ืฉื“ ืชืœื•ื™ ื”ื•ืจืžื•ื ื™ื...

ื›ื™ืฆื“ ื ื™ืชืŸ ืœืžื ื•ืข 70% ืžืžืงืจื™ ืกืจื˜ืŸ ื”ืฉื“? ื˜ืžื•ืงืกื™ืคืŸ. ืžืขื›ื‘ื™ ืืจื•ืžื˜ืื–. 2
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3. ื›ื™ืฆื“ ื ื™ืชืŸ ืœืžื ื•ืข 70% ืžืžืงืจื™ ืกืจื˜ืŸ ื”ืฉื“? ื˜ืžื•ืงืกื™ืคืŸ. ืžืขื›ื‘ื™ ืืจื•ืžื˜ืื–. 2

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ืžื ื™ืขืช ืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ื›ื™ืฆื“ ื˜ื™ืคื•ืœื™ื ืื ื˜ื™-ื”ื•ืจืžื•ื ืœื™ื™ื ื™ื›ื•ืœื™ื ืœืžื ื•ืข ืขื“ 70% ืžืžืงืจื™ ืกืจื˜ืŸ ื”ืฉื“. ื”ื•ื ืžืคืจื˜ ืืช ื”ื”ืฉืคืขื” ื”ืžืฉืžืขื•ืชื™ืช...

ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื˜ืžื•ืงืกื™ืคืŸ ืœืขื•ืžืช ืื ืกื˜ืจื•ื–ื•ืœ?
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4. ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื˜ืžื•ืงืกื™ืคืŸ ืœืขื•ืžืช ืื ืกื˜ืจื•ื–ื•ืœ?

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ืžื ื™ืขืช ืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ืืช ื”ื‘ื—ื™ืจื” ื‘ื™ืŸ ื˜ืžื•ืงืกื™ืคืŸ ื•ืžืขื›ื‘ื™ ืืจื•ืžื˜ืื– ื›ืžื• ืื ืกื˜ืจื•ื–ื•ืœ. ื”ื•ื ืžืคืจื˜ ืืช ื”ื™ื™ืฉื•ืžื™ื ื”ืกืคืฆื™ืคื™ื™ื ืฉืœ ื›ืœ...

ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“
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5. ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ืืช ื”ืงื˜ื’ื•ืจื™ื•ืช ื”ืขื™ืงืจื™ื•ืช ืฉืœ ืชืจื•ืคื•ืช ืื ื“ื•ืงืจื™ื ื™ื•ืช. ื”ื•ื ืžืคืจื˜ ืืช ื”ืฉื™ืžื•ืฉ ื‘ืื’ื•ื ื™ืกื˜ื™ื ืœ-LHRH, SERMs, SERDs...

ืžืชื™ ื ื™ืชืŸ ืœื”ื—ืฉื™ื‘ ืกืจื˜ืŸ ืฉื“ ื›ืžื—ืœื” ืฉื ืจืคืื”? ื”ืื ืจื™ืคื•ื™ ืžืกืจื˜ืŸ ื”ืฉื“ ืืคืฉืจื™? 5
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6. ืžืชื™ ื ื™ืชืŸ ืœื”ื—ืฉื™ื‘ ืกืจื˜ืŸ ืฉื“ ื›ืžื—ืœื” ืฉื ืจืคืื”? ื”ืื ืจื™ืคื•ื™ ืžืกืจื˜ืŸ ื”ืฉื“ ืืคืฉืจื™? 5

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ืืช ื”ืžื•ืฉื’ ืจื™ืคื•ื™ ื‘ืื•ื ืงื•ืœื•ื’ื™ื”. ื”ื•ื ืžื‘ื”ื™ืจ ื›ื™ ืื‘ืŸ ื”ื“ื™ืŸ ืฉืœ ื—ืžืฉ ืฉื ื™ื ืœืœื ืžื—ืœื” ืื™ื ื” ืกื˜ื ื“ืจื˜...

ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. 5 ืื• 10 ืฉื ื™ื ืœืžืขื›ื‘ื™ ืืจื•ืžื˜ืื–? ืืกื˜ืจื•ื’ื ื™ื ืžืขื•ื“ื“ื™ื ืกืจื˜ืŸ ืฉื“. 6
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7. ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. 5 ืื• 10 ืฉื ื™ื ืœืžืขื›ื‘ื™ ืืจื•ืžื˜ืื–? ืืกื˜ืจื•ื’ื ื™ื ืžืขื•ื“ื“ื™ื ืกืจื˜ืŸ ืฉื“. 6

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“ ื•ื”ื•ืจืžื•ื ื•ืชืจืคื™ื”, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ืืช ื”ืชืคืงื™ื“ื™ื ื”ืžื•ืจื›ื‘ื™ื ืฉืœ ืืกื˜ืจื•ื’ื ื™ื ื•ืคืจื•ื’ืกื˜ื™ื ื™ื ื‘ื”ืชืคืชื—ื•ืช ืกืจื˜ืŸ ื”ืฉื“. ื”ื•ื ืžืคืจื˜ ื›ื™ืฆื“ ืืกื˜ืจื•ื’ื ื™ื ืคื•ืขืœื™ื ื›ืžืงื“ืžื™...

ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื”ืื ืคืจื•ื’ืกื˜ื™ื ื™ื ื ื•ื’ื“ื™ื ืœืžื ื™ืขื” ืื• ื˜ื™ืคื•ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“? 7
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8. ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื”ืื ืคืจื•ื’ืกื˜ื™ื ื™ื ื ื•ื’ื“ื™ื ืœืžื ื™ืขื” ืื• ื˜ื™ืคื•ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“? 7

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ืืช ื”ืชืคืงื™ื“ ื”ืžื•ืจื›ื‘ ืฉืœ ืคืจื•ื’ืกื˜ื™ื ื™ื ื•ื ื•ื’ื“ื™-ืคืจื•ื’ืกื˜ื™ื ื™ื ื‘ื˜ื™ืคื•ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื”ื•ื ืžืคืจื˜ ืืช ื”ืืชื’ืจื™ื ื”ืงืœื™ื ื™ื™ื ื•ื”ืคื•ืœื™ื˜ื™ื™ื ืกื‘ื™ื‘...

ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื›ื™ืฆื“ ืœื‘ื—ื•ืจ ืžืขื›ื‘ื™ ืืจื•ืžื˜ืื–? 8
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9. ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื›ื™ืฆื“ ืœื‘ื—ื•ืจ ืžืขื›ื‘ื™ ืืจื•ืžื˜ืื–? 8

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ื˜ื™ืคื•ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ื›ื™ืฆื“ ืœื‘ื—ื•ืจ ืžืขื›ื‘ื™ ืืจื•ืžื˜ืื–. ื”ื•ื ืžืคืจื˜ ืืช ื”ื™ืขื“ืจ ื”ื”ื‘ื“ืœ ื”ืงืœื™ื ื™ ื‘ื™ืŸ ื”ืกื•ื’ื™ื ื”ืกื˜ืจื•ืื™ื“ืœื™ื™ื ื•ื”ืœื-ืกื˜ืจื•ืื™ื“ื™ื™ื. ื“"ืจ...

ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ืื’ื•ื ื™ืกื˜ื™ื ืœ-LHRH ืื• ื›ืจื™ืชืช ืฉื—ืœื•ืช ื•ื—ืฆื•ืฆืจื•ืช ื“ื•-ืฆื“ื“ื™ืช (BSO)? 9
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10. ื˜ื™ืคื•ืœ ื”ื•ืจืžื•ื ืœื™ ื‘ืกืจื˜ืŸ ื”ืฉื“. ืื’ื•ื ื™ืกื˜ื™ื ืœ-LHRH ืื• ื›ืจื™ืชืช ืฉื—ืœื•ืช ื•ื—ืฆื•ืฆืจื•ืช ื“ื•-ืฆื“ื“ื™ืช (BSO)? 9

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ื˜ื™ืคื•ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ืฉื™ื˜ื•ืช ืœื“ื™ื›ื•ื™ ืฉื—ืœืชื™ ืขื‘ื•ืจ ืžื˜ื•ืคืœื•ืช ื˜ืจื•ื-ืžื ื•ืคืื•ื–ืœื™ื•ืช. ื”ื•ื ืžืคืจื˜ ืืช ื”ื‘ื—ื™ืจื” ื‘ื™ืŸ ืื’ื•ื ื™ืกื˜ื™ื ืœ-LHRH ืœื‘ื™ืŸ ื›ืจื™ืชืช...

ื˜ื™ืคื•ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื›ื™ืฆื“ ืœื‘ื—ื•ืจ ื›ื™ืžื•ืชืจืคื™ื” ื ืื•ืื“ื’'ื•ื‘ื ื˜ื™ืช ื•ืื“ื’'ื•ื‘ื ื˜ื™ืช? 10
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11. ื˜ื™ืคื•ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื›ื™ืฆื“ ืœื‘ื—ื•ืจ ื›ื™ืžื•ืชืจืคื™ื” ื ืื•ืื“ื’'ื•ื‘ื ื˜ื™ืช ื•ืื“ื’'ื•ื‘ื ื˜ื™ืช? 10

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ื˜ื™ืคื•ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ืืช ื‘ื—ื™ืจืช ืคืจื•ื˜ื•ืงื•ืœื™ ื”ื›ื™ืžื•ืชืจืคื™ื” ื”ื ื™ืื•-ืื“ื’'ื•ื‘ื ื˜ื™ืช ื•ื”ืื“ื’'ื•ื‘ื ื˜ื™ืช. ื”ื•ื ืžืคืจื˜ ืืช ื”ื™ืชืจื•ื ื•ืช ื”ืžืฉืžืขื•ืชื™ื™ื ืฉืœ ืžืชืŸ ื˜ื™ืคื•ืœ ืžืขืจื›ืชื™...

ืื™ืžื•ื ื•ืชืจืคื™ื” ื‘ืกืจื˜ืŸ ื”ืฉื“ ืื™ืžื•ื ื•ืชืจืคื™ื” ืื™ื ื” ื˜ื™ืคื•ืœ ืงืกื.
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12. ืื™ืžื•ื ื•ืชืจืคื™ื” ื‘ืกืจื˜ืŸ ื”ืฉื“ ืื™ืžื•ื ื•ืชืจืคื™ื” ืื™ื ื” ื˜ื™ืคื•ืœ ืงืกื.

ืžื•ืžื—ื” ืžื•ื‘ื™ืœ ื‘ืื™ืžื•ื ื•ืชืจืคื™ื” ืœืกืจื˜ืŸ ื”ืฉื“, ื“"ืจ ืžืืจืง ืœื™ืคืžืŸ, MD, ืžืกื‘ื™ืจ ืืช ื”ืžืฆื‘ ื”ื ื•ื›ื—ื™ ื•ืืช ื”ืžื’ื‘ืœื•ืช ืฉืœ ืžืขื›ื‘ื™ ื ืงื•ื“ื•ืช ื‘ืงืจื” ื—ื™ืกื•ื ื™ืช ื‘ื˜ื™ืคื•ืœ ื‘ืกืจื˜ืŸ ื”ืฉื“. ื”ื•ื ืžืคืจื˜...

ืฉืคืจ ืืช ืชื•ื›ื ื™ืช ื”ื˜ื™ืคื•ืœ ืฉืœืš ืขื ืคืื ืœ ืฉืœ ืจื•ืคืื™ื ืžื•ื‘ื™ืœื™ื ืฉืžืชืื™ืžื™ื ื‘ื“ื™ื•ืง ืœืžืงืจื” ืฉืœืš.

ืฉืคืจ ืืช ืชื•ื›ื ื™ืช ื”ื˜ื™ืคื•ืœ ืฉืœืš ืขื ืคืื ืœ ืฉืœ ืจื•ืคืื™ื ืžื•ื‘ื™ืœื™ื ืฉืžืชืื™ืžื™ื ื‘ื“ื™ื•ืง ืœืžืงืจื” ืฉืœืš.

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