{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T14:57:13Z","timestamp":1785077833638,"version":"3.55.0"},"reference-count":161,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012172","name":"Breast Cancer Canada","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012172","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+\/HER2\u2212) early breast cancer (EBC) is the most common breast cancer subtype and encompasses a biologically heterogeneous group of tumours. Endocrine therapy (ET) remains the cornerstone of treatment, but decisions regarding chemotherapy, cyclin-dependent kinase 4 and 6 (CDK4\/6) inhibitors, and bone-modifying agents must be tailored to tumour biology, clinical stage, and menopausal status. REAL Canadian Breast Cancer Alliance (REAL Alliance), a pan-Canadian group of breast cancer specialists, convened to develop national clinical consensus recommendations for the systemic management of HR+\/HER2\u2212 EBC. Using a structured consensus process, 28 recommendations were endorsed, spanning neoadjuvant and adjuvant systemic therapy, surgical considerations, and use of bisphosphonates. Key recommendations include the selective use of neoadjuvant chemotherapy for high-risk or locally advanced disease; genomic testing to guide chemotherapy decisions, particularly in postmenopausal patients; ET as the foundation of adjuvant therapy with intensification using CDK4\/6 inhibitors in higher-risk patients; and adjuvant bisphosphonates in postmenopausal women to reduce recurrence and improve survival. These consensus recommendations provide practical, evidence-based guidance to support individualized, patient-centred management of HR+\/HER2\u2212 EBC in the Canadian context.<\/jats:p>","DOI":"10.3390\/curroncol33020112","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T17:42:13Z","timestamp":1770918133000},"page":"112","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HR+\/HER2\u2212 Early Breast Cancer 2025"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7434-2263","authenticated-orcid":false,"given":"Sandeep","family":"Sehdev","sequence":"first","affiliation":[{"name":"The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4201-8930","authenticated-orcid":false,"given":"Anil Abraham","family":"Joy","sequence":"additional","affiliation":[{"name":"Cross Cancer Institute, University of Alberta, Edmonton, AB T6G 1Z2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Boileau","sequence":"additional","affiliation":[{"name":"Jewish General Hospital, McGill University, Montreal, QC H3T 1E2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Bouganim","sequence":"additional","affiliation":[{"name":"McGill University Health Centre, McGill University, Montreal, QC H4A 3J1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4818-318X","authenticated-orcid":false,"given":"Christine","family":"Brezden-Masley","sequence":"additional","affiliation":[{"name":"Marvelle Koffler Breast Centre, Mount Sinai Hospital, University of Toronto, Toronto, ON M5G 1X5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey Q.","family":"Cao","sequence":"additional","affiliation":[{"name":"Arthur J.E. Child Comprehensive Cancer Centre, University of Calgary, Calgary, AB T2N 5G2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1080-0998","authenticated-orcid":false,"given":"David W.","family":"Cescon","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Chia","sequence":"additional","affiliation":[{"name":"BC Cancer\u2014Vancouver, University of British Columbia, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Edwards","sequence":"additional","affiliation":[{"name":"Dr. H. Bliss Murphy Cancer Center, Memorial University of Newfoundland, St. John\u2019s, NL A1B 3V6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4111-2757","authenticated-orcid":false,"given":"Karen A.","family":"Gelmon","sequence":"additional","affiliation":[{"name":"BC Cancer\u2014Vancouver, University of British Columbia, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna J.","family":"Jerzak","sequence":"additional","affiliation":[{"name":"Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aalok","family":"Kumar","sequence":"additional","affiliation":[{"name":"BC Cancer\u2014Surrey, University of British Columbia, Vancouver, BC V3V 1Z2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara","family":"Laing","sequence":"additional","affiliation":[{"name":"Dr. H. Bliss Murphy Cancer Center, Memorial University of Newfoundland, St. John\u2019s, NL A1B 3V6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2581-4903","authenticated-orcid":false,"given":"Nathalie","family":"LeVasseur","sequence":"additional","affiliation":[{"name":"BC Cancer\u2014Vancouver, University of British Columbia, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6571-4587","authenticated-orcid":false,"given":"Christine","family":"Simmons","sequence":"additional","affiliation":[{"name":"BC Cancer\u2014Vancouver, University of British Columbia, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Webster","sequence":"additional","affiliation":[{"name":"Arthur J.E. Child Comprehensive Cancer Centre, University of Calgary, Calgary, AB T2N 5G2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4344-7913","authenticated-orcid":false,"given":"Mita","family":"Manna","sequence":"additional","affiliation":[{"name":"Saskatoon Cancer Centre, University of Saskatchewan, Saskatoon, SK S7N 4H4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of Patient Advocacy, Breast Cancer Canada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"dju055","DOI":"10.1093\/jnci\/dju055","article-title":"US Incidence of Breast Cancer Subtypes Defined by Joint Hormone Receptor and HER2 Status","volume":"106","author":"Howlader","year":"2014","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"191","DOI":"10.3747\/co.27.5769","article-title":"A Population-Based Analysis of Breast Cancer Incidence and Survival by Subtype in Ontario Women","volume":"27","author":"Seung","year":"2020","journal-title":"Curr. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Cortet, M., Bertaut, A., Molini\u00e9, F., Bara, S., Beltjens, F., Coutant, C., and Arveux, P. (2018). Trends in Molecular Subtypes of Breast Cancer: Description of Incidence Rates between 2007 and 2012 from Three French Registries. BMC Cancer, 18.","DOI":"10.1186\/s12885-018-4080-8"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"100567","DOI":"10.1016\/j.jcpo.2025.100567","article-title":"Capturing Breast Cancer Subtypes in Cancer Registries: Insights into Real-World Incidence and Survival","volume":"44","author":"Protani","year":"2025","journal-title":"J. Cancer Policy"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"E615","DOI":"10.1503\/cmaj.240095","article-title":"Projected Estimates of Cancer in Canada in 2024","volume":"196","author":"Brenner","year":"2024","journal-title":"CMAJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"6536","DOI":"10.3390\/curroncol31110484","article-title":"Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HER2+ Breast Cancer in Both the Early and Metastatic Setting","volume":"31","author":"Manna","year":"2024","journal-title":"Curr. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Early Breast Cancer Trialists\u2019 Collaborative Group (EBCTCG) (2005). Effects of Chemotherapy and Hormonal Therapy for Early Breast Cancer on Recurrence and 15-Year Survival: An Overview of the Randomised Trials. Lancet, 365, 1687\u20131717.","DOI":"10.1016\/S0140-6736(05)66544-0"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Early Breast Cancer Trialists\u2019 Collaborative Group (EBCTCG) (2008). Adjuvant Chemotherapy in Oestrogen-Receptor-Poor Breast Cancer: Patient-Level Meta-Analysis of Randomised Trials. Lancet, 371, 29\u201340.","DOI":"10.1016\/S0140-6736(08)60069-0"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Early Breast Cancer Trialists\u2019 Collaborative Group (Ebctcg) (2012). Comparisons between Different Polychemotherapy Regimens for Early Breast Cancer: Meta-Analyses of Long-Term Outcome among 100 000 Women in 123 Randomised Trials. Lancet, 379, 432\u2013444.","DOI":"10.1016\/S0140-6736(11)61625-5"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1016\/S0140-6736(18)33137-4","article-title":"Increasing the Dose Intensity of Chemotherapy by More Frequent Administration or Sequential Scheduling: A Patient-Level Meta-Analysis of 37 298 Women with Early Breast Cancer in 26 Randomised Trials","volume":"393","author":"Gray","year":"2019","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1016\/S0140-6736(23)00285-4","article-title":"Anthracycline-Containing and Taxane-Containing Chemotherapy for Early-Stage Operable Breast Cancer: A Patient-Level Meta-Analysis of 100 000 Women from 86 Randomised Trials","volume":"401","author":"Braybrooke","year":"2023","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.1200\/JCO.1997.15.7.2483","article-title":"Effect of Preoperative Chemotherapy on Local-Regional Disease in Women with Operable Breast Cancer: Findings from National Surgical Adjuvant Breast and Bowel Project B-18","volume":"15","author":"Fisher","year":"1997","journal-title":"J. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1200\/JCO.20.03399","article-title":"Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline","volume":"39","author":"Korde","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1093\/oxfordjournals.jncimonographs.a003469","article-title":"Preoperative Chemotherapy in Patients with Operable Breast Cancer: Nine-Year Results from National Surgical Adjuvant Breast and Bowel Project B-18","volume":"30","author":"Wolmark","year":"2001","journal-title":"J. Natl. Cancer Inst. Monogr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4165","DOI":"10.1200\/JCO.2003.12.005","article-title":"The Effect on Tumor Response of Adding Sequential Preoperative Docetaxel to Preoperative Doxorubicin and Cyclophosphamide: Preliminary Results From National Surgical Adjuvant Breast and Bowel Project Protocol B-27","volume":"21","author":"Bear","year":"2003","journal-title":"J. Clin. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"8715","DOI":"10.1158\/1078-0432.CCR-05-0539","article-title":"Feasibility and Tolerability of Sequential Doxorubicin\/Paclitaxel Followed by Cyclophosphamide, Methotrexate, and Fluorouracil and Its Effects on Tumor Response as Preoperative Therapy","volume":"11","author":"Gianni","year":"2005","journal-title":"Clin. Cancer Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4224","DOI":"10.1200\/JCO.2001.19.22.4224","article-title":"Preoperative Chemotherapy in Primary Operable Breast Cancer: Results from the European Organization for Research and Treatment of Cancer Trial 10902","volume":"19","author":"Julien","year":"2001","journal-title":"J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/S0140-6736(13)62422-8","article-title":"Pathological Complete Response and Long-Term Clinical Benefit in Breast Cancer: The CTNeoBC Pooled Analysis","volume":"384","author":"Cortazar","year":"2014","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.annonc.2023.11.016","article-title":"Early Breast Cancer: ESMO Clinical Practice Guideline for Diagnosis, Treatment and Follow-Up","volume":"35","author":"Loibl","year":"2024","journal-title":"Ann. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/j.annonc.2023.08.017","article-title":"Understanding Breast Cancer Complexity to Improve Patient Outcomes: The St Gallen International Consensus Conference for the Primary Therapy of Individuals with Early Breast Cancer 2023","volume":"34","author":"Curigliano","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3726","DOI":"10.1200\/JCO.2005.04.7985","article-title":"Gene Expression and Benefit of Chemotherapy in Women with Node-Negative, Estrogen Receptor-Positive Breast Cancer","volume":"24","author":"Paik","year":"2006","journal-title":"J. Clin. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1056\/NEJMoa1804710","article-title":"Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer","volume":"379","author":"Sparano","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1056\/NEJMoa2108873","article-title":"21-Gene Assay to Inform Chemotherapy Benefit in Node-Positive Breast Cancer","volume":"385","author":"Kalinsky","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1056\/NEJMoa1602253","article-title":"70-Gene Signature as an Aid to Treatment Decisions in Early-Stage Breast Cancer","volume":"375","author":"Cardoso","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/S1470-2045(21)00007-3","article-title":"70-Gene Signature as an Aid for Treatment Decisions in Early Breast Cancer: Updated Results of the Phase 3 Randomised MINDACT Trial with an Exploratory Analysis by Age","volume":"22","author":"Piccart","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"PO3-15-04","DOI":"10.1158\/1538-7445.SABCS23-PO3-15-04","article-title":"Abstract PO3-15-04: Oncotype DX Recurrence Score as an Informative Tool to Optimize Neoadjuvant Therapy in HR-Positive, HER2-Negative Breast Cancers","volume":"84","author":"Luzhna","year":"2024","journal-title":"Cancer Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"5588","DOI":"10.1245\/s10434-021-10457-5","article-title":"Is the 21-Gene Recurrence Score on Core Needle Biopsy Equivalent to Surgical Specimen in Early-Stage Breast Cancer? A Comparison of Gene Expression Between Paired Core Needle Biopsy and Surgical Specimens","volume":"28","author":"Orozco","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s10549-020-06075-6","article-title":"Concordance of the 21-Gene Assay between Core Needle Biopsy and Resection Specimens in Early Breast Cancer Patients","volume":"186","author":"Qi","year":"2021","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"P3-12-21","DOI":"10.1158\/1557-3265.SABCS24-P3-12-21","article-title":"Abstract P3-12-21: NeoTAILOR: A Phase II Biomarker-Directed Approach to Guide Neoadjuvant Therapy for Patients with Clinical Stage II\/III ER+, HER2\u2212 Negative Breast Cancer","volume":"31","author":"Bagegni","year":"2025","journal-title":"Clin. Cancer Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1200\/JCO.22.00069","article-title":"Biomarkers for Adjuvant Endocrine and Chemotherapy in Early-Stage Breast Cancer: ASCO Guideline Update","volume":"40","author":"Andre","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1200\/JCO.2005.02.6914","article-title":"Prognostic Value of Pathologic Complete Response after Primary Chemotherapy in Relation to Hormone Receptor Status and Other Factors","volume":"24","author":"Guarneri","year":"2006","journal-title":"J. Clin. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S1470-2045(21)00589-1","article-title":"Residual Cancer Burden after Neoadjuvant Chemotherapy and Long-Term Survival Outcomes in Breast Cancer: A Multicentre Pooled Analysis of 5161 Patients","volume":"23","author":"Yau","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"TPS615","DOI":"10.1200\/JCO.2025.43.16_suppl.TPS615","article-title":"A Phase III Trial Evaluating Addition of Adjuvant Chemotherapy to Ovarian Function Suppression + Endocrine Therapy in Premenopausal Women with pN0-1, HR+\/HER2\u2212 Breast Cancer (BC) and Oncotype Recurrence Score (RS) \u226425 (OFSET): NRG-BR009","volume":"43","author":"Mamounas","year":"2025","journal-title":"J. Clin. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Wang, Y., Li, Y., Liang, J., Zhang, N., and Yang, Q. (2022). Chemotherapy-Induced Amenorrhea and Its Prognostic Significance in Premenopausal Women With Breast Cancer: An Updated Meta-Analysis. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.859974"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1038\/s41523-018-0090-6","article-title":"21-Gene Assay as Predictor of Chemotherapy Benefit in HER2-Negative Breast Cancer","volume":"4","author":"Geyer","year":"2018","journal-title":"NPJ Breast Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2557","DOI":"10.1200\/JCO.21.02759","article-title":"Endocrine Therapy Response and 21-Gene Expression Assay for Therapy Guidance in HR+\/HER2\u2013 Early Breast Cancer","volume":"40","author":"Nitz","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_37","unstructured":"(2025). A Randomized Phase III Trial Comparing Axillary Lymph Node Dissection to Axillary Radiation in Breast Cancer Patients (cT1-3 N1) Who Have Positive Sentinel Lymph Node Disease After Neoadjuvant Chemotherapy (Standard No. NCT01901094)."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1023\/A:1013128213451","article-title":"Preoperative Treatment of Postmenopausal Breast Cancer Patients with Letrozole: A Randomized Double-Blind Multicenter Study","volume":"12","author":"Eiermann","year":"2001","journal-title":"Ann. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"5108","DOI":"10.1200\/JCO.2005.04.005","article-title":"Neoadjuvant Treatment of Postmenopausal Breast Cancer With Anastrozole, Tamoxifen, or Both in Combination: The Immediate Preoperative Anastrozole, Tamoxifen, or Combined With Tamoxifen (IMPACT) Multicenter Double-Blind Randomized Trial","volume":"23","author":"Smith","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1200\/JCO.2010.31.6950","article-title":"Randomized Phase II Neoadjuvant Comparison Between Letrozole, Anastrozole, and Exemestane for Postmenopausal Women with Estrogen Receptor\u2013Rich Stage 2 to 3 Breast Cancer: Clinical and Biomarker Outcomes and Predictive Value of the Baseline PAM50-Based Intrinsic Subtype\u2014ACOSOG Z1031","volume":"29","author":"Ellis","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1001\/jamaoncol.2021.2132","article-title":"Neoadjuvant Endocrine Therapy in Clinical Practice: A Review","volume":"7","author":"Sella","year":"2021","journal-title":"JAMA Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1200\/JCO.18.01624","article-title":"Randomized Phase II Study Evaluating Palbociclib in Addition to Letrozole as Neoadjuvant Therapy in Estrogen Receptor\u2013Positive Early Breast Cancer: PALLET Trial","volume":"37","author":"Johnston","year":"2019","journal-title":"J. Clin. Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"4055","DOI":"10.1158\/1078-0432.CCR-16-3206","article-title":"NeoPalAna: Neoadjuvant Palbociclib, a Cyclin-Dependent Kinase 4\/6 Inhibitor, and Anastrozole for Clinical Stage 2 or 3 Estrogen Receptor\u2013Positive Breast Cancer","volume":"23","author":"Ma","year":"2017","journal-title":"Clin. Cancer Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1158\/1078-0432.CCR-19-1425","article-title":"Potent Cell-Cycle Inhibition and Upregulation of Immune Response with Abemaciclib and Anastrozole in neoMONARCH, Phase II Neoadjuvant Study in HR+\/HER2\u2212 Breast Cancer","volume":"26","author":"Hurvitz","year":"2020","journal-title":"Clin. Cancer Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1200\/JCO.2020.38.15_suppl.505","article-title":"Letrozole + Ribociclib versus Letrozole + Placebo as Neoadjuvant Therapy for ER+ Breast Cancer (FELINE Trial)","volume":"38","author":"Khan","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S1470-2045(19)30786-7","article-title":"Ribociclib plus Letrozole versus Chemotherapy for Postmenopausal Women with Hormone Receptor-Positive, HER2-Negative, Luminal B Breast Cancer (CORALLEEN): An Open-Label, Multicentre, Randomised, Phase 2 Trial","volume":"21","author":"Prat","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Zhang, Z., Zhao, X., and Chen, J. (2024). Adjuvant and Neoadjuvant Therapy with or without CDK4\/6 Inhibitors in HR+\/HER2\u2212 Early Breast Cancer: A Systematic Review and Meta-Analysis. Front. Pharmacol., 15.","DOI":"10.3389\/fphar.2024.1438288"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1056\/NEJMoa1609709","article-title":"Ribociclib as First-Line Therapy for HR-Positive, Advanced Breast Cancer","volume":"375","author":"Hortobagyi","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3638","DOI":"10.1200\/JCO.2017.75.6155","article-title":"MONARCH 3: Abemaciclib As Initial Therapy for Advanced Breast Cancer","volume":"35","author":"Goetz","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1001\/jamaoncol.2019.6650","article-title":"Effect of Pembrolizumab Plus Neoadjuvant Chemotherapy on Pathologic Complete Response in Women With Early-Stage Breast Cancer: An Analysis of the Ongoing Phase 2 Adaptively Randomized I-SPY2 Trial","volume":"6","author":"Nanda","year":"2020","journal-title":"JAMA Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1038\/s41591-024-03415-7","article-title":"Pembrolizumab and Chemotherapy in High-Risk, Early-Stage, ER+\/HER2\u2212 Breast Cancer: A Randomized Phase 3 Trial","volume":"31","author":"Cardoso","year":"2025","journal-title":"Nat. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1038\/s41591-024-03414-8","article-title":"Neoadjuvant Nivolumab and Chemotherapy in Early Estrogen Receptor-Positive Breast Cancer: A Randomized Phase 3 Trial","volume":"31","author":"Loi","year":"2025","journal-title":"Nat. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1001\/jama.2017.11470","article-title":"Effect of Axillary Dissection vs No Axillary Dissection on 10-Year Overall Survival Among Women With Invasive Breast Cancer and Sentinel Node Metastasis: The ACOSOG Z0011 (Alliance) Randomized Clinical Trial","volume":"318","author":"Giuliano","year":"2017","journal-title":"JAMA"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1056\/NEJMoa2313487","article-title":"Omitting Axillary Dissection in Breast Cancer with Sentinel-Node Metastases","volume":"390","author":"Tvedskov","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/S1470-2045(14)70460-7","article-title":"Radiotherapy or Surgery of the Axilla after a Positive Sentinel Node in Breast Cancer (EORTC 10981-22023 AMAROS): A Randomised, Multicentre, Open-Label, Phase 3 Non-Inferiority Trial","volume":"15","author":"Donker","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1016\/j.annonc.2022.09.159","article-title":"Overall Survival in the OlympiA Phase III Trial of Adjuvant Olaparib in Patients with Germline Pathogenic Variants in BRCA1\/2 and High-Risk, Early Breast Cancer","volume":"33","author":"Geyer","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"3987","DOI":"10.1200\/JCO.20.02514","article-title":"Abemaciclib Combined With Endocrine Therapy for the Adjuvant Treatment of HR+, HER2\u2212, Node-Positive, High-Risk, Early Breast Cancer (monarchE)","volume":"38","author":"Johnston","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1056\/NEJMoa2305488","article-title":"Ribociclib plus Endocrine Therapy in Early Breast Cancer","volume":"390","author":"Slamon","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"TPS611","DOI":"10.1200\/JCO.2024.42.16_suppl.TPS611","article-title":"Tailored Axillary Surgery with or without Axillary Lymph Node Dissection Followed by Radiotherapy in Patients with Clinically Node-Positive Breast Cancer (OPBC-03\/SAKK 23\/16\/IBCSG 57-18\/ABCSG-53\/GBG-101-TAXIS)","volume":"42","author":"Weber","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1200\/JCO-25-00099","article-title":"Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update","volume":"43","author":"Park","year":"2025","journal-title":"J. Clin. Oncol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"7226","DOI":"10.3390\/curroncol31110533","article-title":"Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for Clinical Staging of Patients Newly Diagnosed with Breast Cancer","volume":"31","author":"Cao","year":"2024","journal-title":"Curr. Oncol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10549-022-06522-6","article-title":"A Canadian National Guideline on the Neoadjuvant Treatment of Invasive Breast Cancer, Including Patient Assessment, Systemic Therapy, and Local Management Principles","volume":"193","author":"Gandhi","year":"2022","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"RF2-01","DOI":"10.1158\/1557-3265.SABCS24-RF2-01","article-title":"Abstract RF2-01: Factors Influencing Additional Nodal Disease and Pathologic Nodal Upstaging with Axillary Dissection in Patients with Residual Node-Positive Breast Cancer After Neoadjuvant Chemotherapy Enrolled on Alliance A011202 Clinical Trial","volume":"31","author":"Boughey","year":"2025","journal-title":"Clin. Cancer Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1056\/NEJMoa2414859","article-title":"Omitting Regional Nodal Irradiation after Response to Neoadjuvant Chemotherapy","volume":"392","author":"Mamounas","year":"2025","journal-title":"N. Engl. J. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"3292","DOI":"10.1200\/JCO-25-01747","article-title":"Postmastectomy Radiation Therapy: An ASTRO-ASCO-SSO Clinical Practice Guideline","volume":"43","author":"Jimenez","year":"2025","journal-title":"J. Clin. Oncol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"LB1-01","DOI":"10.1158\/1557-3265.SABCS24-LB1-01","article-title":"Abstract LB1-01: Immediate Breast Surgery versus Deferral of Surgery in Women Aged 70+ Years with Operable Breast Cancer: Patient-Level Meta-Analysis of the Three Randomised Trials among 1082 Women","volume":"31","author":"Hills","year":"2025","journal-title":"Clin. Cancer Res."},{"key":"ref_67","unstructured":"Choosing Wisely, ABIM Foundation Society of Surgical Oncology (2025, August 25). Don\u2019t Routinely Use Sentinel Node Biopsy in Clinically Node Negative Women \u226570 Years of Age with Early Stage Hormone Receptor Positive, HER2 Negative Invasive Breast Cancer. Available online: https:\/\/www.surgonc.org\/wp-content\/uploads\/2024\/04\/FINAL_Choosing_Wisely_5.30.23-SSO-5things-List_2021-Updates.pdf."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1159\/000546080","article-title":"St. Gallen\/Vienna 2025 Summary of Key Messages on Therapy in Early Breast Cancer from the 2025 St. Gallen International Breast Cancer Conference","volume":"20","author":"Ditsch","year":"2025","journal-title":"Breast Care"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1001\/jamaoncol.2017.1261","article-title":"Use of Molecular Tools to Identify Patients With Indolent Breast Cancers With Ultralow Risk Over 2 Decades","volume":"3","author":"Esserman","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"2416","DOI":"10.1200\/JCO.2016.67.0182","article-title":"Selection of Optimal Adjuvant Chemotherapy Regimens for Human Epidermal Growth Factor Receptor 2 (HER2)\u2013Negative and Adjuvant Targeted Therapy for HER2-Positive Breast Cancers: An American Society of Clinical Oncology Guideline Adaptation of the Cancer Care Ontario Clinical Practice Guideline","volume":"34","author":"Denduluri","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1200\/JCO.2018.78.8604","article-title":"Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Clinical Practice Guideline Focused Update","volume":"36","author":"Denduluri","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1200\/JCO.20.02510","article-title":"Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Guideline Update","volume":"39","author":"Denduluri","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1200\/JCO.18.00028","article-title":"West German Study PlanB Trial: Adjuvant Four Cycles of Epirubicin and Cyclophosphamide Plus Docetaxel Versus Six Cycles of Docetaxel and Cyclophosphamide in HER2-Negative Early Breast Cancer","volume":"37","author":"Nitz","year":"2019","journal-title":"J. Clin. Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1038\/s41416-021-01690-6","article-title":"The Impact of Anthracyclines in Intermediate and High-Risk HER2-Negative Early Breast Cancer\u2014A Pooled Analysis of the Randomised Clinical Trials PlanB and SUCCESS C","volume":"126","author":"Janni","year":"2022","journal-title":"Br. J. Cancer"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s10549-018-5055-9","article-title":"Anthracycline and Taxane-Based Chemotherapy versus Docetaxel and Cyclophosphamide in the Adjuvant Treatment of HER2-Negative Breast Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"174","author":"Caparica","year":"2019","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"4486","DOI":"10.3390\/curroncol31080335","article-title":"The Omission of Anthracycline Chemotherapy in Women with Early HER2-Negative Breast Cancer\u2014A Systematic Review and Meta-Analysis","volume":"31","author":"Rush","year":"2024","journal-title":"Curr. Oncol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2647","DOI":"10.1200\/JCO.2016.71.4147","article-title":"Anthracyclines in Early Breast Cancer: The ABC Trials\u2014USOR 06-090, NSABP B-46-I\/USOR 07132, and NSABP B-49 (NRG Oncology)","volume":"35","author":"Blum","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"e12576","DOI":"10.1200\/JCO.2018.36.15_suppl.e12576","article-title":"Four versus Six Cycles of Docetaxel and Cyclophosphamide (TC) in Early Stage Hormone Positive Breast Cancer","volume":"36","author":"Basu","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_79","first-page":"GS3-03","article-title":"Impact of Anthracyclines in High Genomic Risk Node-Negative HR+\/HER2\u2212 Breast Cancer","volume":"31","author":"Chen","year":"2024","journal-title":"San Antonio Breast Cancer Symp. SABCS"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1200\/JCO.2024.42.16_suppl.511","article-title":"Association of MammaPrint Index and 3-Year Outcome of Patients with HR+HER2\u2212 Early-Stage Breast Cancer Treated with Chemotherapy with or without Anthracycline","volume":"42","author":"Graham","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1200\/JCO.2016.70.5400","article-title":"Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline","volume":"35","author":"Armenian","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1038\/nrcardio.2015.65","article-title":"Cardiotoxicity of Anticancer Treatments","volume":"12","author":"Ewer","year":"2015","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2869","DOI":"10.1002\/cncr.11407","article-title":"Congestive Heart Failure in Patients Treated with Doxorubicin: A Retrospective Analysis of Three Trials","volume":"97","author":"Swain","year":"2003","journal-title":"Cancer"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1200\/OP.23.00665","article-title":"Breast Cancer Therapies: A Cardiac Perspective","volume":"20","author":"Abdallah","year":"2024","journal-title":"JCO Oncol. Pract."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1161\/CIRCULATIONAHA.114.013777","article-title":"Early Detection of Anthracycline Cardiotoxicity and Improvement with Heart Failure Therapy","volume":"131","author":"Cardinale","year":"2015","journal-title":"Circulation"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1200\/OP.23.00494","article-title":"Cardiotoxicity of Agents Used in Patients With Breast Cancer","volume":"20","author":"Zagami","year":"2024","journal-title":"JCO Oncol. Pract."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1200\/JCO.2015.65.1505","article-title":"Breast Cancer Therapy-Related Cardiac Dysfunction in Adult Women Treated in Routine Clinical Practice: A Population-Based Cohort Study","volume":"34","author":"Thavendiranathan","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1093\/jnci\/djae107","article-title":"Long-Term Cardiovascular Disease Risk after Anthracycline and Trastuzumab Treatments in US Breast Cancer Survivors","volume":"116","author":"Vo","year":"2024","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"100074","DOI":"10.1016\/j.medp.2025.100074","article-title":"Anthracycline-Induced Cardiotoxicity: Emerging Mechanisms and Therapies","volume":"2","author":"Ling","year":"2025","journal-title":"Med. Plus"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1200\/JCO.2015.64.0409","article-title":"Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study","volume":"34","author":"Armenian","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s40959-025-00305-w","article-title":"CARDIAC-STAR: Prevalence of Cardiovascular Comorbidities in Patients with HR+\/HER2\u2212 Metastatic Breast Cancer","volume":"11","author":"Dent","year":"2025","journal-title":"Cardio-Oncology"},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Early Breast Cancer Trialists\u2019 Collaborative Group (EBCTCG), Davies, C., Godwin, J., Gray, R., Clarke, M., Cutter, D., Darby, S., McGale, P., Pan, H.C., and Taylor, C. (2011). Relevance of Breast Cancer Hormone Receptors and Other Factors to the Efficacy of Adjuvant Tamoxifen: Patient-Level Meta-Analysis of Randomised Trials. Lancet, 378, 771\u2013784.","DOI":"10.1016\/S0140-6736(11)60993-8"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1200\/JCO.22.01065","article-title":"Adjuvant Endocrine Therapy in Premenopausal Breast Cancer: 12-Year Results From SOFT","volume":"41","author":"Francis","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/S0140-6736(12)61963-1","article-title":"Long-Term Effects of Continuing Adjuvant Tamoxifen to 10 Years versus Stopping at 5 Years after Diagnosis of Oestrogen Receptor-Positive Breast Cancer: ATLAS, a Randomised Trial","volume":"381","author":"Davies","year":"2013","journal-title":"Lancet"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1200\/jco.2013.31.18_suppl.5","article-title":"aTTom: Long-Term Effects of Continuing Adjuvant Tamoxifen to 10 Years versus Stopping at 5 Years in 6953 Women with Early Breast Cancer","volume":"31","author":"Gray","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1200\/JCO.18.01160","article-title":"Adjuvant Endocrine Therapy for Women With Hormone Receptor\u2013Positive Breast Cancer: ASCO Clinical Practice Guideline Focused Update","volume":"37","author":"Burstein","year":"2019","journal-title":"J. Clin. Oncol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1200\/EDBK_350358","article-title":"Personalizing Adjuvant Endocrine Therapy for Early-Stage Hormone Receptor\u2013Positive Breast Cancer","volume":"42","author":"Pistilli","year":"2022","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1200\/JCO.24.00886","article-title":"Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer\u2014Cyclin-Dependent Kinase 4 and 6 Inhibitors: ASCO Guideline Rapid Recommendation Update","volume":"42","author":"Freedman","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1056\/NEJMoa1701830","article-title":"20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years","volume":"377","author":"Pan","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1200\/JCO.23.01994","article-title":"Adjuvant Abemaciclib Plus Endocrine Therapy for Hormone Receptor\u2013Positive, Human Epidermal Growth Factor Receptor 2\u2013Negative, High-Risk Early Breast Cancer: Results From a Preplanned monarchE Overall Survival Interim Analysis, Including 5-Year Efficacy Outcomes","volume":"42","author":"Rastogi","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_101","unstructured":"(2025, November 29). Breast Cancer Canada 2024 Progress Report. Available online: https:\/\/www.flipsnack.com\/E7FBBD99E8C\/2024-progress-report\/full-view.html."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.annonc.2025.10.005","article-title":"Overall Survival with Abemaciclib in Early Breast Cancer","volume":"37","author":"Johnston","year":"2025","journal-title":"Ann. Oncol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.annonc.2024.10.015","article-title":"A Phase III Trial of Adjuvant Ribociclib plus Endocrine Therapy versus Endocrine Therapy Alone in Patients with HR-Positive\/HER2-Negative Early Breast Cancer: Final Invasive Disease-Free Survival Results from the NATALEE Trial","volume":"36","author":"Hortobagyi","year":"2025","journal-title":"Ann. Oncol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1001\/jamaoncol.2025.3700","article-title":"Ribociclib Plus Endocrine Therapy in Hormone Receptor\u2013Positive\/ERBB2 -Negative Early Breast Cancer: 4-Year Outcomes from the NATALEE Randomized Clinical Trial","volume":"11","author":"Fasching","year":"2025","journal-title":"JAMA Oncol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"105858","DOI":"10.1016\/j.esmoop.2025.105858","article-title":"Adjuvant Ribociclib plus Nonsteroidal Aromatase Inhibitor Therapy in Patients with HR-Positive\/HER2-Negative Early Breast Cancer: 5-Year Follow-up of NATALEE Efficacy Outcomes and Updated Overall Survival","volume":"10","author":"Crown","year":"2025","journal-title":"ESMO Open"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"17588359251326710","DOI":"10.1177\/17588359251326710","article-title":"Clinician\u2019s Guide: Expert Insights on the Use of CDK4\/6 Inhibitors in Patients with Early Breast Cancer","volume":"17","author":"Hussain","year":"2025","journal-title":"Ther. Adv. Med. Oncol."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Jerzak, K.J., Sehdev, S., Boileau, J.-F., Brezden-Masley, C., Califaretti, N., Edwards, S., Gordon, J., Henning, J.-W., LeVasseur, N., and Railton, C. (2025). Multidisciplinary Practical Guidance for Implementing Adjuvant CDK4\/6 Inhibitors for Patients with HR-Positive, HER2-Negative Early Breast Cancer in Canada. Curr. Oncol., 32.","DOI":"10.3390\/curroncol32080444"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1200\/JCO.2023.41.16_suppl.503","article-title":"Effects of Ovarian Ablation or Suppression on Breast Cancer Recurrence and Survival: Patient-Level Meta-Analysis of 14,993 Pre-Menopausal Women in 25 Randomized Trials","volume":"41","author":"Gray","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1200\/JCO.22.01064","article-title":"Adjuvant Exemestane With Ovarian Suppression in Premenopausal Breast Cancer: Long-Term Follow-Up of the Combined TEXT and SOFT Trials","volume":"41","author":"Pagani","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/S1470-2045(21)00758-0","article-title":"Aromatase Inhibitors versus Tamoxifen in Premenopausal Women with Oestrogen Receptor-Positive Early-Stage Breast Cancer Treated with Ovarian Suppression: A Patient-Level Meta-Analysis of 7030 Women from Four Randomised Trials","volume":"23","author":"Bradley","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_111","unstructured":"(2024). Novartis Pharmaceuticals A Phase IIIb Study to Characterize the Effectiveness and Safety of Adjuvant Ribociclib in a Wide Patient Population with HR+ HER2\u2212 Early Breast Cancer (Adjuvant WIDER)."},{"key":"ref_112","doi-asserted-by":"crossref","unstructured":"Early Breast Cancer Trialists\u2019 Collaborative Group (EBCTCG) (2015). Aromatase Inhibitors versus Tamoxifen in Early Breast Cancer: Patient-Level Meta-Analysis of the Randomised Trials. Lancet, 386, 1341\u20131352.","DOI":"10.1016\/S0140-6736(15)61074-1"},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"(2009). The BIG 1-98 Collaborative Group Letrozole Therapy Alone or in Sequence with Tamoxifen in Women with Breast Cancer. N. Engl. J. Med., 361, 766\u2013776.","DOI":"10.1056\/NEJMoa0810818"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"4196","DOI":"10.1158\/1078-0432.CCR-13-0804","article-title":"Breast Cancer Index Identifies Early-Stage Estrogen Receptor\u2013Positive Breast Cancer Patients at Risk for Early- and Late-Distant Recurrence","volume":"19","author":"Zhang","year":"2013","journal-title":"Clin. Cancer Res."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"EVIDoa2300267","DOI":"10.1056\/EVIDoa2300267","article-title":"Clinical and Genomic Risk for Late Breast Cancer Recurrence and Survival","volume":"3","author":"Sparano","year":"2024","journal-title":"NEJM Evid."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.molonc.2016.09.009","article-title":"Tumor Cell Dormancy","volume":"11","author":"Gomis","year":"2017","journal-title":"Mol. Oncol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1093\/jnci\/djab202","article-title":"The Incidence of Breast Cancer Recurrence 10\u201332 Years After Primary Diagnosis","volume":"114","author":"Pedersen","year":"2022","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1093\/jnci\/dji250","article-title":"Randomized Trial of Letrozole Following Tamoxifen as Extended Adjuvant Therapy in Receptor-Positive Breast Cancer: Updated Findings from NCIC CTG MA.17","volume":"97","author":"Goss","year":"2005","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1056\/NEJMoa1604700","article-title":"Extending Aromatase-Inhibitor Adjuvant Therapy to 10 Years","volume":"375","author":"Goss","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1016\/S1470-2045(21)00352-1","article-title":"Extended Therapy with Letrozole as Adjuvant Treatment of Postmenopausal Patients with Early-Stage Breast Cancer: A Multicentre, Open-Label, Randomised, Phase 3 Trial","volume":"22","author":"Mansutti","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1056\/NEJMoa2104162","article-title":"Duration of Adjuvant Aromatase-Inhibitor Therapy in Postmenopausal Breast Cancer","volume":"385","author":"Gnant","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/S0140-6736(25)01013-X","article-title":"Extending the Duration of Endocrine Treatment for Early Breast Cancer: Patient-Level Meta-Analysis of 12 Randomised Trials of Aromatase Inhibitors in 22 031 Postmenopausal Women Already Treated with at Least 5 Years of Endocrine Therapy","volume":"406","author":"Braybrooke","year":"2025","journal-title":"Lancet"},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Bekes, I., and Huober, J. (2023). Extended Adjuvant Endocrine Therapy in Early Breast Cancer Patients\u2014Review and Perspectives. Cancers, 15.","DOI":"10.3390\/cancers15164190"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"104437","DOI":"10.1016\/j.breast.2025.104437","article-title":"Real-World Risk of Recurrence and Treatment Outcomes with Adjuvant Endocrine Therapy in Patients with Stage II-III HR+\/HER2\u2212 Early Breast Cancer","volume":"81","author":"Tolaney","year":"2025","journal-title":"Breast"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"S337","DOI":"10.1016\/j.annonc.2024.08.233","article-title":"292P Real-World Evidence on Risk of Recurrence (ROR) in Patients (Pts) with Node-Negative (N0) and Node-Positive HR+\/HER2\u2013 Early Breast Cancer (EBC) from US Electronic Health Records (EHR)","volume":"35","author":"Jhaveri","year":"2024","journal-title":"Ann. Oncol."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s10549-022-06518-2","article-title":"Barriers and Facilitators to Taking CDK4\/6 Inhibitors among Patients with Metastatic Breast Cancer: A Qualitative Study","volume":"192","author":"Conley","year":"2022","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"S336","DOI":"10.1016\/j.annonc.2023.09.555","article-title":"378O Persistence under Abemaciclib and Endocrine Treatment (ABA+ET) in Patients with Advanced Breast Cancer (aBC): First Results of the Randomized IMPACT Trial Comparing Patient Coaching with the MASCC Oral Agent Teaching Tool (MOATT) versus Local Routine Patient Coaching (LC)","volume":"34","author":"Welslau","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.annonc.2025.09.141","article-title":"TRADE: A Phase II Trial to Assess the Tolerability of Abemaciclib Dose Escalation in Early-Stage HR+\/HER2\u2212 Breast Cancer","volume":"37","author":"Mayer","year":"2025","journal-title":"Ann. Oncol."},{"key":"ref_129","doi-asserted-by":"crossref","unstructured":"Chan, A., Nixon, N., Al-Khaifi, M., Bestavros, A., Blyth, C., Cheung, W.Y., Hamm, C., Joly-Mischlich, T., Manna, M., and McFarlane, T. (2025). Optimizing Adjuvant Care in Early Breast Cancer: Multidisciplinary Strategies and Innovative Models from Canadian Centers. Curr. Oncol., 32.","DOI":"10.3390\/curroncol32070402"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1200\/JCO.23.02225","article-title":"Germline Testing in Patients With Breast Cancer: ASCO-Society of Surgical Oncology Guideline","volume":"42","author":"Bedrosian","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Weber, E., Carmona-Gonzalez, C.A., Boucher, M., Eisen, A., Laing, K., Melvin, J., Schrader, K.A., Sehdev, S., Wong, S.M., and Gelmon, K.A. (2025). Canadian Recommendations for Germline Genetic Testing of Patients with Breast Cancer: A Call to Action. Curr. Oncol., 32.","DOI":"10.20944\/preprints202503.2053.v1"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1200\/JCO-24-02263","article-title":"Endocrine Therapy Omission in Estrogen Receptor\u2013Low (1%\u201310%) Early-Stage Breast Cancer","volume":"43","author":"Choong","year":"2025","journal-title":"J. Clin. Oncol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1056\/NEJMoa2112651","article-title":"Event-Free Survival with Pembrolizumab in Early Triple-Negative Breast Cancer","volume":"386","author":"Schmid","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_134","doi-asserted-by":"crossref","unstructured":"Early Breast Cancer Trialists\u2019 Collaborative Group (EBCTCG) (2015). Adjuvant Bisphosphonate Treatment in Early Breast Cancer: Meta-Analyses of Individual Patient Data from Randomised Trials. Lancet, 386, 1353\u20131361.","DOI":"10.1016\/S0140-6736(15)60908-4"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1093\/jnci\/djz215","article-title":"Phase III Randomized Trial of Bisphosphonates as Adjuvant Therapy in Breast Cancer: S0307","volume":"112","author":"Gralow","year":"2020","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1200\/JCO.21.02647","article-title":"Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer: ASCO-OH (CCO) Guideline Update","volume":"40","author":"Eisen","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1016\/j.annonc.2020.07.019","article-title":"Bone Health in Cancer: ESMO Clinical Practice Guidelines","volume":"31","author":"Coleman","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1001\/jamaoncol.2021.1854","article-title":"Prognosis of Patients With Early Breast Cancer Receiving 5 Years vs 2 Years of Adjuvant Bisphosphonate Treatment: A Phase 3 Randomized Clinical Trial","volume":"7","author":"Friedl","year":"2021","journal-title":"JAMA Oncol."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"e24793","DOI":"10.1016\/j.heliyon.2024.e24793","article-title":"Benefit of Adjuvant Bisphosphonates in Early Breast Cancer Treated with Contemporary Systemic Therapy: A Meta-Analysis of Randomized Control Trials","volume":"10","author":"Mittal","year":"2024","journal-title":"Heliyon"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1001\/jamaoncol.2021.1516","article-title":"Adjuvant Zoledronate Therapy for Women With Breast Cancer\u2014Effective Treatment or Fool\u2019s Gold?","volume":"7","author":"Desnoyers","year":"2021","journal-title":"JAMA Oncol."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.jbo.2015.06.001","article-title":"Are Adjuvant Bisphosphonates Now Standard of Care of Women with Early Stage Breast Cancer? A Debate from the Canadian Bone and the Oncologist New Updates Meeting","volume":"4","author":"Jacobs","year":"2015","journal-title":"J. Bone Oncol."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S1470-2045(18)30862-3","article-title":"Adjuvant Denosumab in Postmenopausal Patients with Hormone Receptor-Positive Breast Cancer (ABCSG-18): Disease-Free Survival Results from a Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial","volume":"20","author":"Gnant","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/S1470-2045(19)30687-4","article-title":"Adjuvant Denosumab in Early Breast Cancer (D-CARE): An International, Multicentre, Randomised, Controlled, Phase 3 Trial","volume":"21","author":"Coleman","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_144","unstructured":"Jerzak, K.J., Raphael, J., Desautels, D., Blanchette, P.S., Tyono, I., and Pritchard, K.I. (2025, November 29). Bone-Targeted Therapy in Early Breast Cancer|CancerNetwork. Available online: https:\/\/www.cancernetwork.com\/view\/bone-targeted-tx."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/S1470-2045(14)70302-X","article-title":"Adjuvant Zoledronic Acid in Patients with Early Breast Cancer: Final Efficacy Analysis of the AZURE (BIG 01\/04) Randomised Open-Label Phase 3 Trial","volume":"15","author":"Coleman","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1200\/JCO-24-02782","article-title":"Fertility Preservation in People With Cancer: ASCO Guideline Update","volume":"43","author":"Su","year":"2025","journal-title":"J. Clin. Oncol."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"vi160","DOI":"10.1093\/annonc\/mdt199","article-title":"Cancer, Pregnancy and Fertility: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up\u2020","volume":"24","author":"Peccatori","year":"2013","journal-title":"Ann. Oncol."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"e100037","DOI":"10.1200\/EDBK_100037","article-title":"Patient-Centered Care in the Management of Cancer During Pregnancy","volume":"43","author":"Sorouri","year":"2023","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1200\/OP-24-00453","article-title":"Multidisciplinary Management of Pregnancy-Associated Breast Cancer","volume":"21","author":"Roesch","year":"2025","journal-title":"JCO Oncol. Pract."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1200\/OP-24-00867","article-title":"Pregnancy-Associated Breast Cancer: Key Concepts for Optimizing Diagnosis and Treatment","volume":"21","author":"Kesireddy","year":"2025","journal-title":"JCO Oncol. Pract."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/s10549-008-0159-2","article-title":"Weekly Epirubicin in the Treatment of Gestational Breast Cancer (GBC)","volume":"115","author":"Peccatori","year":"2009","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.ejso.2008.04.010","article-title":"Pregnancy Associated Breast Cancer","volume":"35","author":"Royo","year":"2009","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/PPO.0b013e3181ce46f9","article-title":"Breast Cancer During Pregnancy: Maternal and Fetal Outcomes","volume":"16","author":"Cardonick","year":"2010","journal-title":"Cancer J."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/S1470-2045(12)70261-9","article-title":"Treatment of Breast Cancer during Pregnancy: An Observational Study","volume":"13","author":"Loibl","year":"2012","journal-title":"Lancet Oncol."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1186\/s13058-014-0500-0","article-title":"Outcomes of Children Exposed in Uteroto Chemotherapy for Breast Cancer","volume":"16","author":"Murthy","year":"2014","journal-title":"Breast Cancer Res."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1038\/s41416-019-0563-x","article-title":"In Utero Exposure to Breast Cancer Treatment: A Population-Based Perinatal Outcome Study","volume":"121","author":"Safi","year":"2019","journal-title":"Br. J. Cancer"},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1097\/01.AOG.0000558888.89911.f0","article-title":"Safety of Taxane Chemotherapy in Breast Cancer During Pregnancy [28O]","volume":"133","author":"So","year":"2019","journal-title":"Obstet. Gynecol."},{"key":"ref_158","doi-asserted-by":"crossref","unstructured":"Poggio, F., Tagliamento, M., Pirrone, C., Soldato, D., Conte, B., Molinelli, C., Cosso, M., Fregatti, P., Del Mastro, L., and Lambertini, M. (2020). Update on the Management of Breast Cancer during Pregnancy. Cancers, 12.","DOI":"10.3390\/cancers12123616"},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1159\/000501473","article-title":"Tamoxifen Exposure during Pregnancy: A Systematic Review and Three More Cases","volume":"15","author":"Buonomo","year":"2019","journal-title":"Breast Care"},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1056\/NEJMoa2212856","article-title":"Interrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer","volume":"388","author":"Partridge","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_161","first-page":"S1557","article-title":"5-Year Follow-up Results from the POSITIVE (Pregnancy Outcome and Safety of Interrupting Therapy for Women with Endocrine Responsive Breast Cancer) Trial","volume":"36","author":"Pagani","year":"2025","journal-title":"ESMO Open"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/2\/112\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T05:13:20Z","timestamp":1771996400000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/2\/112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":161,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["curroncol33020112"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33020112","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]}}}