Some Breast Cancers Require Longer Tx
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EXCELLENT article! Thanks so much. Unfortunately I'll bet I'm on the 10 year AI plan. Oh well.
Very interesting. A must read!
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A few questions incase anyone can answer....I did send my onco an email asking what her thoughts were and if she is keeping any patients on the 10 year plan, but no response yet.
So does the oncotypeDX tell you what kind of "er molecule" you have?
Does the study look at all stages? All types (lobular, ductal, inflammatory) of cancer?
The HER2 status can be considered "negative" even if you score a 1...do they look at the value of HER2 or simply go by "negative" status (since recent studies show herceptin actually benefits some "negative" HER2 gals).
And I don't suppose there is any way to know if the women that relapsed 5-10 years after dx would have done so with or without treatment; sort of the same problem wondering if we should take the meds out of the gate---many of us would not recur even if we did nothing.
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Lot's of missing pieces
"possibly indicating a need for more than 5 years of adjuvant hormonal therapy"
"HER2-negative tumors with a high score on the estrogen panel of a
genetic test had a recurrence rate of 13.6% during years 5 to 10 after
diagnosis, more than double the recurrence rate during the first 5
years."Where's the data saying more than 5yrs helps with this.
"The findings came from a new analysis of the landmark Arimidex, Tamoxifen Alone or in Combination
(ATAC) randomized trial, which showed improved survival in breast
cancer patients who received 5 years of adjuvant hormonal therapy with
an aromatase inhibitor instead of tamoxifen."How does this study tell us that more than 5yrs is beneficial. I think it tells us that AI are more effective than Tamoxifen in postmenopausal women.
I know prolonging endocrine therapy(past 5yrs) is being studied. I doubt much more will be known 2 1/2 yrs from now when I complete 5 yrs of Tamox.
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At my last appointment with my MO she said it is likely that I will need to be on something for 15 years with the new research that is coming out. I just bit my tongue - in my mind I was thinking, "hell no! I was only going to do 5 anyway!" Quality of life on these things is ridiculous! I will be most proud of myself to hit the five year mark - it has not been an easy road for me. Personally, I will need more proof of not being over treated, as well as proof of not doing more harm than good. No proof they even work for BRCA+ women. Sigh. One size fits all should not be something for cancer, all types, stages, weight, age, etc. with these drugs. Sorry to be so negative - her 15 year remark really depressed me.
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If I were at an earlier stage, I'd most probably be on the 10-year plan given I was 100% ER+ and my mammos showed almost 99% dense tissue at dx (my estimate). I've been NED 6 years and anti-estrogen therapy continues to work for me. I am currently on Tamoxifen and am putting my hopes on two studies of earlier stage women (ATLAS and aTTom) which show strong evidence of benefits with continuing Tamoxifen beyond 5 years.
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