Abstract
Endocrine therapy remains one of the primary treatment modalities for estrogen receptor (ER) positive breast cancer, serving a pivotal role in improving patient outcomes and extending survival. Nevertheless, the gradual emergence of endocrine resistance continues to limit its clinical efficacy. In recent years, advances in molecular biology and genomics have driven the development of innovative technologies and therapeutic strategies in this field. The present review highlights the latest progress in endocrine therapy for breast cancer, including the introduction of next-generation selective ER degraders (SERDs), ER antagonists/degraders and selective ER modulators (SERMs). In addition, combination strategies integrating endocrine therapy with small-molecule inhibitors of critical signaling pathways, such as PI3K/AKT/mTOR and CDK4/6, have demonstrated promising potential in overcoming resistance. Cutting-edge technologies, such as single-cell sequencing and organoid models, are providing novel insights into treatment monitoring and the implementation of personalized therapy. Looking ahead, precision medicine platforms powered by artificial intelligence and big data are expected to further refine therapeutic strategies and ultimately improve patient prognosis. Collectively, endocrine therapy for breast cancer is evolving toward a more diversified, precise and individualized approach, offering patients broader treatment options and enhanced survival benefits.