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Combined treatment ups survival of breast cancer

Last Updated: 2007-04-03 17:00:01 -0400 (Reuters Health)

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Combined treatment ups survival of breast cancer

There are many different treatment approaches for early breast cancer. Personal characteristics such as your age and menopausal status, as well as the cancer's stage and hormone receptor status are considered when developing the best treatment approach for YOU. Every breast cancer is different and every treatment plan is different. One research study isn't likely to give you and your doctors all the answers about your treatment plan. Still, the study reviewed here, along with other research results and the knowledge and experience of your doctors, helps you and your doctor decide what is best for YOU.

Several points from this study are notable:

  • Women who got chemotherapy for early breast cancer were 17% more likely to be alive 5 or more years after diagnosis. They were less likely to have a recurrence.
  • Hormonal therapy is often used to treat early breast cancer. In this study, tamoxifen was the hormonal therapy used in ALL the women, whether or not they had chemotherapy. Tamoxifen works by blocking estrogen so it can't make the breast cancer grow. At the time the study was done, tamoxifen was the typical hormonal therapy used in both premenopausal and postmenopausal women. Today, premenopausal women still get tamoxifen. But postmenopausal women often receive a different hormonal therapy, an aromatase inhibitor, which works differently than tamoxifen. Aromatase inhibitors are believed to be somewhat better than tamoxifen in reducing the risk of recurrence.
  • In PREMENOPAUSAL women, doctors may recommend either removing or suppressing the ovaries in addition to other treatments. Shutting down the ovaries with medication or removing them surgically are both very effective ways to reduce or eliminate your body's main source of estrogen. With less estrogen to fuel hormone-receptor-positive breast cancer cells, the growth of these cells may be controlled or stopped. This isn't done in postmenopausal women because their ovaries have already shut down. In this study, premenopausal women who had their ovaries removed or suppressed with medication didn't do any better than those who did not. But the researchers caution that there still may be a benefit to ovary removal or suppression in some premenopausal women.

If you are considering treatment options for early breast cancer, these research results are worth considering. Still, they don't mean that chemotherapy is definitely right for you or that removing or suppressing your ovaries is definitely wrong for you. Your treatment plan should address YOUR specific situation and give YOU the best care possible. Learning as much as you can and talking about it with your doctor is a very important part of that.

More Research News on Hormonal Therapy (44 Articles)

NEW YORK (Reuters Health) - Adding chemotherapy to the estrogen-blocking drug tamoxifen improves the survival of early breast cancer, according to the results of two studies conducted by the Adjuvant Breast Cancer (ABC) Trials Collaborative Group.

By contrast, preventing the secretion of estrogen from the ovaries seems to offer no benefit for most women.

In the ABC Chemotherapy trial, Dr. Judith Bliss, from The Institute of Cancer Research in Sutton, UK, and colleagues assessed the outcomes of 1991 patients, between 28 and 81 years of age, who received prolonged (5 years) tamoxifen therapy with or without standard chemotherapy. Some of the premenopausal women were also treated with ovarian removal (ablation) or suppression, which stops the glands from secreting hormones.

The chemotherapy group experienced fewer recurrences of their cancer than the comparison group, but the difference fell short of statistical significance, according to the report in the Journal of the National Cancer Institute. Still, chemotherapy did reduce the overall risk of death by 17 percent.

The benefit of chemotherapy in reducing cancer recurrence emerged early, while it took at least 5 years for the survival benefit to become apparent, the researchers note.

Further analysis showed that chemotherapy provided the greatest survival benefit in women younger than 50 years, especially premenopausal women not treated with ovarian ablation or suppression.

To better understand the benefits, if any, of ovarian ablation/suppression, Bliss' team conducted the ABC Ovarian Ablation or Suppression trial, which involved 2144 women, who were premenopausal or just beginning menopause, who were given tamoxifen, with or without chemotherapy, and were randomly selected to receive or not receive ovarian ablation/suppression.

Ovarian ablation/suppression provided no improvement in survival, nor reduced cancer recurrences, the report indicates.

Despite these findings, the authors note that there may be a role for ovarian ablation/suppression in women younger than 40, especially those not given chemotherapy, but further studies are needed.

SOURCE: Journal of the National Cancer Institute, April 4, 2007.


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