Least Aggressive Breast Cancer Still Poses Long-Term Risk..

cp418

http://health.usnews.com/health-news/news/articles/2012/09/18/least-aggressive-breast-cancer-still-poses-long-term-risk-study-finds

Least Aggressive Breast Cancer Still Poses Long-Term Risk, Study Finds

"These and earlier findings strongly support molecular subtypes as important independent predictors of breast cancer mortality," Haque said. "It is important for women with breast cancer -- even those diagnosed with the least aggressive form of the disease -- to be an advocate for their own health and speak to their doctors about treatment options."

wallycat

Of course, each of us knows the risk of recurrence is always there....

I am curious what "extended" treatements they mean.  Clearly tamoxifen is out since it can cause its own ramifications longer than 5 years (according to the studies) and aromatase inhibitors can cause other issues long term....

sigh...sometimes I feel like a sitting duck.  

I do not know if I am luminal A or B but I did ask my onco about Evista for a few years.....I guess that conversation needs to happen again.

cp418

There are current ongoing studies for extending AIs beyond 5 years.  However, it comes with more side effects for bone loss, chronic body joint pain, and more as you stated.  Then it takes years to collect all this information and apply statistics to medically interpret it.  For now these drugs are all we have along with healthy diet and life choices - - - trying to control all these side effects.  I sure hope it won't take another 30-50 years to come up with better treatments.    I get tired of all the obesity and exercise articles - - I know more women with breast, ovarian, uterine and non-hodgkins lymphoma who have low to normal BMI and led active healthy life style when diagnosed. 

voraciousreader

NCCN guidelines 2012 professional version pages 93-98 discusses the current literature regarding endocrine therapy. For women who were premenopausal at diagnosis, the gold standard is 5 years of Tamoxifen. If they become post menopausal during therapy, AFTER completing the 5 years, they can consider 5 years of an AI. The evidence for the second 5 years presently is not as strong (2B). Hopefully we will know sooner than later what to do.

voraciousreader

Furthermore, new evidence suggests that for women who complete 5 years of Tamoxifen, at 15 years following completion,6 more lives out of 100 are saved compared to those who do not complete 5 years.

doxie

wallycat - A definition of HER2- Luminal B is somewhat of a moving target.  Generally I've read that a K-67 of 20 or more and/or a mitotic score of 3 is indicative of high proliferation, thus a more agressive cancer and Luminal B.  Using the Oncotype score to determine Luminal B is more difficult because the limited info provided, just ER, PR and HER2 rates.  The proliferation results are figured into the total score, but not broken out.  

 I think it's important early on to know where you are in the Luminal A-B range.  It can and should effect treatment choices.  But now that you are 5 years  out, it doesn't make much difference since the chance of recurrance after 5 years are similar for A and B.  Congratulations on passing that milestone!

This is relatively new, if you want to dig deeper on the subject.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3326541/?tool=pubmed