Table 13. Recommendations of intensive adjuvant endocrine therapy for HR positive premenopausal breast cancer patients.

Stratification	Level I recommendations	Level II recommendations
Patients who have completed the initial 5-year TAM treatment and require extended therapy	(I) Extended adjuvant TAM for up to 10 years in premenopausal patients (1A)	−
	(II) AI can be used sequentially for 5 years in patients whose menopause is confirmed (1A)
Patients who have completed the initial 5 years of OFS + TAM, and the therapy is well tolerated	Sequential AI treatment for menopausal patients for 5 years (2A)	Premenopausal patients treated with TAM for 5 years (2B)
Patients who have completed the initial 5 years of OFS + AI, and the therapy is well tolerated	3–5-year AI treatment for menopausal patients (2A)	Premenopausal patients treated with TAM for 5 years (2B) or OFS + AI for 5 years (2B)

TAM, tamoxifen; OFS, ovarian function suppression; AI, aromatase inhibitor.