For a patient requiring adjuvant endocrine therapy for localized breast cancer, would you use fulvestrant if they were intolerant to both aromatase inhibitor and tamoxifen?  

I think you may run into coverage issues since fulvestrant is not approved for the treatment of early breast cancer. For patients who don't tolerate AI or tamoxifen, I normally try Fareston (toremifene). I have a small handful of patients in my panel that have tolerated that when they haven't tolera...

One of the reasons fulvestrant was not developed in the adjuvant setting is related to the feasibility of monthly intramuscular injections, particularly after the CONFIRM trial established high dose fulvestrant as the proper dose and the need for that two IM injections monthly. There were early effo...

I have had a similar situation and agree that Fulvestrant most likely won't be covered nor perhaps tolerated for 5-10 years. I also have used Torimefene and have found that most patients tolerate this better. Although it is also labeled for metastatic post menopausal patients, it is a SERM and now g...