A 55-year-old postmenopausal woman with T1N0M0, ER-positive, HER2-negative invasive ductal carcinoma is being planned for adjuvant endocrine therapy. Which drug is the first-line standard adjuvant endocrine agent for her?

• A Tamoxifen
• B Goserelin
• C Fulvestrant
• D Letrozole ✓

Explanation

Aromatase inhibitors (letrozole, anastrozole, exemestane) are the standard first-line adjuvant endocrine therapy for postmenopausal women with hormone receptor-positive breast cancer, based on superior disease-free survival compared to tamoxifen in trials such as ATAC and BIG 1-98. Tamoxifen is standard for premenopausal women. Fulvestrant is used in advanced disease. Goserelin is an ovarian suppression agent.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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