Up until November of 2017, women who reached the 5-year cancer free mark following a diagnosis and subsequent treatment of breast cancer, breathed a sigh of relief. They believed that this marked the beginning of a cancer free life. Not necessarily so, a recent report claims.
According to a November report in the New England Journal of Medicine, many of these women run the risk of developing new malignancies up to 20 years following their initial diagnosis. This information comes on the heels of a lengthy examination of 88 clinical trials. These trials involved the testing of nearly 63,000 women who were initially diagnosed with estrogen receptor positive tumors in their breasts.
The protocol in recent years has been to treat these women with chemotherapy, radiation and/or surgery—or sometimes a combination of the three. They then followed up their treatment with a five year course of tamoxifen or another aromatase inhibitor. The idea behind the ongoing treatment was to kill off any lingering cancer cells the radiation, chemotherapy or surgery may have missed. All the women in the aforementioned study were, in fact, deemed cancer free at the five year mark.
The recurrence rate for the highest risk women in the study group—those who originally had the largest tumors that had spread beyond their breasts—is raising alarms. 41 percent of those women experienced a recurrence over a 15 year period. 10 percent of those women with the lowest risk of recurrence were diagnosed with cancer again over that same period of time.
Dr. Daniel Hayes of the University of Michigan Comprehensive Cancer Center in Ann Arbor, Michigan served as senior study author for this report. He doesn’t want to raise fear via this study, but instead wants both doctors and patients to become acutely aware of its findings.
“We know that adjuvant (hormone based) therapy for five years substantially reduces the risk of recurrence and mortality,” he explains. “We now have good evidence that extending adjuvant (hormone based) therapy beyond five years continues to suppress and reduce recurrence and mortality.”
Women with breast cancer and survivors should talk with their doctors about extending the course of adjuvant therapy for an additional five years. Though some may be hesitant to continue these therapies due to menopausal symptoms, it could wind up saving their lives.
Albert Farias wasn’t part of this study. A cancer researcher at the Keck School of Medicine of the University of Southern California in Los Angeles, he is in agreement with Dr. Hayes and the others involved.
“Breast cancer cells can travel from the primary tumor to the lymph nodes and can circulate throughout the body undetectable with current screening methods, and over time these circulating cancer cells can attach to other organs in the body and this is generally when there is a cancer recurrence,” he says. “One way that adjuvant breast cancer treatment works is to kill and/or stop the undetectable cancer cells from growing and dividing.”
While this new information may fill some breast cancer survivors with fear, they should use this fear to their advantage and have a serious conversation with their doctor. If they are among the high risk group that participated in this study, a new course of adjuvant therapy may be in the cards for them.