Background: Aromatase inhibitors are considered standard adjuvant endocrine treatment of
postmenopausal women with hormone receptor-positive breast cancer, but it remains
uncertain whether aromatase inhibitors should be given upfront or sequentially with
tamoxifen. Awaiting results from ongoing randomized trials, we examined prognostic factors
of an early relapse among patients in the BIG 1-98 trial to aid in treatment choices. Patients
and methods: Analyses included all 7707 eligible patients treated on BIG 1-98. The median …

It is hoped that when the results of the sequential arms of the Breast International Group
(BIG) 1-98 trial in comparison to immediate letrozole are known, it will become clear whether
immediate aromatase inhibitor or sequential tamoxifen followed by aromatase inhibitor is the
preferable approach. These results may not provide a clear answer for the individual patient
in the clinic, however. Even after these results are known, a better understanding of factors
influencing treatment decisions will be required.In this paper, Mauriac and colleagues …