After surgery, women diagnosed with breast cancer face the risk of the breast cancer coming back (recurrence). Recurrence can happen at any time. But the risk of recurrence is highest during the first 3 years after treatment. To lower the risk of recurrence in postmenopausal women diagnosed with hormone-receptor-positive early breast cancer, hormonal therapy usually is prescribed for 5 years after the initial treatment. Treatment that comes after surgery or another initial treatment is called adjuvant therapy.
For years, tamoxifen was the hormonal therapy of choice for women diagnosed with hormone-receptor-positive early breast cancer. But in 2005, large clinical studies showed that aromatase inhibitors worked better than tamoxifen to reduce the risk of the cancer coming back in postmenopausal women diagnosed with hormone-receptor-positive breast cancer. So aromatase inhibitors — Arimidex (chemical name: anastrozole), Aromasin (chemical name: exemestane), and Femara (chemical name: letrozole) — now are used more often than tamoxifen.
Both tamoxifen and aromatase inhibitors can cause side effects. Tamoxifen may cause hot flashes. Aromatase inhibitors may cause muscle and joint aches and pains. A study reports on the results of several different studies looking at how often side effects made women stop taking hormonal therapy. The study also looked at how stopping hormonal therapy affected the women's risk of dying.
The researchers found that side effects are causing a large number of women to stop taking hormonal therapy early instead of taking it as prescribed for 5 years. These women have a higher risk of recurrence and a higher risk of dying from breast cancer.
It's likely that other factors besides side effects play a role in the risky decision to stop hormonal therapy early. Some women may need to put everything related to cancer behind them after initial diagnosis and treatment. Lingering depression also may play a role. For other women, the cost of hormonal therapy may be a reason. Some women just may not understand the importance of adjuvant hormonal therapy or don't have good communication with their doctors.
Still, all these reasons are overshadowed by the reality that breast cancer can come back. Adjuvant hormonal therapy reduces that risk. Anyone prescribed adjuvant hormonal therapy must remember this.
There are good ways to get rid of any obstacles stopping you from doing all you can to lower your recurrence risk. If side effects are a major problem for you, talk to your doctor about ways to manage them. You may also be able to switch to a different hormonal therapy.
For more information, visit the Breastcancer.org section Staying on Track with Treatment. You can read about why it's so important to stick to your treatment plan, as well as ways to manage side effects after radiation, chemotherapy, and hormonal therapy. If you're taking adjuvant hormonal therapy medicine now, stick with it as prescribed. If you're thinking of stopping early, talk to your doctor first. Together, you can find a solution that is best for YOU.
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