Sadra Medical Journal

Hormone Therapy in Hormone-Receptor-Positive Breast Cancer: A Review of Survival Benefits and Challenges

Document Type : Review Article

Authors

Dena Firouzabadi 1
Navid Esmaeilzadeh Shahri 1
Mohammad Amin Jafarzadeh 1, 2
Fatemeh Soflaeishahrbabak 3
Maryam Shahriarfar 1

1 Department of Clinical Pharmacy, Shiraz School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran

2 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

3 Faculty of Pharmacy and Pharmaceutical Science, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran

https://doi.org/10.30476/smsj.2026.109136.1704
Abstract
This narrative review focused on the importance of endocrine therapy in patients with hormone-receptor-positive breast cancer. While this subtype of the disease generally had a better prognosis compared to other types of breast cancer, the need for long-term hormonal treatment continued to present numerous challenges in daily clinical practice. According to published evidence, agents such as tamoxifen, letrozole, anastrozole, exemestane, and fulvestrant could reduce the risk of recurrence and decrease mortality, ultimately leading to improved survival outcomes. At the same time, patients commonly experienced several adverse effects, including menopausal symptoms, musculoskeletal pain, reduced bone mineral density, cognitive decline, and issues related to sexual health. These side effects were strongly associated with poor treatment adherence. In this paper, the impact of hormonal agents on survival was summarized alongside the most important challenges associated with treatment complications. Additionally, some supportive methods and newer therapeutic approaches were reviewed as potential strategies for managing these problems. Overall, endocrine therapy should still be considered an essential component of treatment for hormone-receptor-positive breast cancer. However, the effectiveness of this approach was highly dependent on patients’ awareness of the necessity of continuing treatment and the available strategies for mitigating its side effects.

Keywords

Breast Neoplasms
Hormone Therapy
Endocrine System
Survival Rate
Drug-Related Side Effects and Adverse Reactions
Adverse Effects
Medication Adherence
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Sadra Medical Journal
Volume 14, Issue 2
Spring 2026
Pages 518-540

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