所有乳腺癌亚型中，七成为激素受体阳性。这些患者的辅助内分泌治疗起到了关键作用。尽管传统上要求持续五年，但在相当比例的患者中，复发的风险仍然较高。一些试验报告称，通过延长辅助内分泌治疗的时间可以降低晚期复发的风险。然而，内分泌治疗的最佳持续时间仍然存在争议。较新的数据仅显示延长至七到十年的方案带来了轻微的益处。此外，延长治疗可能会引发更多的副作用。因此，对符合条件的患者进行合适的选取以进行延长的辅助治疗非常重要。基因组检测和工具可以帮助更好地识别具有晚期复发风险的患者，这些工具包括患者和肿瘤的特征。综上所述，延长辅助内分泌治疗的益处的大小基于对五年后复发风险的精确估计。这必须与长期内分泌治疗的副作用和竞争风险进行权衡。对于中等风险的患者，七年似乎是最佳持续时间，而具有高风险特征的患者可以考虑进行长达十年的内分泌治疗。

Seventy percent of all breast cancer subtypes are hormone receptor-positive. Adjuvant endocrine therapy in these patients plays a key role. Despite the traditional duration of a 5-year intake, the risk of relapse remains elevated in a substantial proportion of patients. Several trials report that the risk of late recurrence is reduced by the extension of adjuvant endocrine therapy beyond 5 years. However, the optimal duration of endocrine therapy is still a matter of debate. The newer data only show a marginal benefit resulting from extension beyond 7 to 10 years. Furthermore, extension may be associated with more side effects. Thus, the adequate selection of patients qualifying for an extended adjuvant therapy is of importance. Tools/genomic tests, which include the characteristics of the patient and the tumor, may help to better identify patients with a risk of a late relapse. Taken together, the magnitude of benefit for extended adjuvant endocrine therapy is based on the precise estimation of the risk of relapse after 5 years. This must be balanced against the long-term side effects of endocrine treatment and the competing risks. For patients with an intermediate risk, 7 years appears to be the optimal duration, and in those with high-risk features, endocrine therapy up to 10 years may be considered.