A study published last week in The New England Journal of Medicine could soon, if its authors have their way, see breast cancer survivors extend their endocrine therapy well beyond the normal five years.
This study looked at data on nearly 63,000 women who had previously been successfully treated for estrogen-receptor (ER)–positive breast cancer. What it ultimately found was that the women’s rates of recurrence began to climb after their hormone treatments ended. Those risks continued to climb for 20 years.
And how advanced the cancer was when it was originally diagnosed appeared to directly influence how likely it was to come back. For women in the highest risk group – those who were originally diagnosed with 4 to 9 lymph nodes involved – the rate of recurrence topped 40%. That stands in stark contrast to women in the T1N0 category (no lymph nodes involved) with a 13% rate of recurrence.
Currently, most breast cancer patients are put on tamoxifen or an aromatase inhibitor after their treatment is completed. Tamoxifen works by binding to estrogen receptors in the breasts, blocking estrogen from being used by cancer cells. Aromatase inhibitors, which are given to post-menopausal breast cancer survivors, can block the production of estrogen in the first place. Both drugs have the potential for significant side effects. Remaining on them is sometimes challenging.
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