الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Adjuvant Tamoxifen as selective estrogen receptor modulator in patients with early breast cancer, hormone receptor positive either premenopausal or postmenopausal patients added benefit regarding the disease free survival, time to recurrence and overall survival taking into consideration the side effects that forced the patients to stop the treatment or shifting to Aromatase inhibitors if become postmenopausal with benefit in disease free survival in trials done for sequential treatment after 2 to 3 years of Tamoxifen.
The role of Aromatase inhibitors is crucial in postmenopausal patients with early breast cancer and with hormone receptor positive as adjuvant treatment. The 5 year adjuvant Aromatase inhibitors added benefit regarding the disease free survival and less side effects but not overall survival benefit.
In our retrospective study we included 561 postmenopausal women presented to Alexandria clinical oncology department from 2007 to 2012 with early breast cancer, and hormone receptor positive. 284 patients were in the Tamoxifen group representing 50.6% of the patients, 114 patients with in the Aromatase inhibitors group representing 20.3% of the patients and 164 patients with no available data. We compared adjuvant Tamoxifen for 5 years to adjuvant Aromatase inhibitors for 5 years regarding the disease free survival as the primary end point and the overall survival and toxicity profile as the secondary end points.
The results of our study showed that Aromatase inhibitors group had better 5 years disease free survival than Tamoxifen group with p value 0.036. Regarding the overall survival, there was no statistically significant difference with p value 0.68.
Regarding the toxicity Tamoxifen group had more gynecological, thromboembolic and gastrointestinal side effects than Aromatase inhibitors. However Aromatase inhibitors group had significant side effects as arthritis and osteoporosis as adverse events in 1.5 % of the patients.