The ABCSG-8/ARNO-95 combined analysis and the MA.17 trial established which of the following extended adjuvant strategies in postmenopausal women with hormone-receptor-positive early breast cancer who have completed 5 years of tamoxifen?

• A Switch to an aromatase inhibitor (AI) after 5 years of tamoxifen reduces disease-free survival events
• B Sequential AI therapy after tamoxifen is inferior to tamoxifen alone for 10 years
• C Sequential AI is beneficial only in node-negative disease
• D Extended letrozole for 5 years after tamoxifen significantly improves disease-free survival ✓

Explanation

The MA.17 trial (letrozole vs placebo after 5 years of tamoxifen) demonstrated a significant improvement in disease-free survival with extended letrozole, reducing annual hazard of recurrence by ~42%. The ABCSG-8/ARNO-95 combined analysis also confirmed the benefit of switching from tamoxifen to anastrozole. These trials collectively established extended AI therapy as a standard adjuvant strategy regardless of nodal status.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.