Health Encyclopedia

 

Health Encyclopedia Home



Newer Anti-Estrogen Treatment May Benefit Younger Breast Cancer Survivors

Newer Anti-Estrogen Treatment May Benefit Younger Breast Cancer Survivors

SUNDAY, June 1, 2014 (HealthDay News) -- A new type of anti-estrogen drug appears to work better than the estrogen-blocking drug tamoxifen in preventing recurrences of breast cancer in certain women, a new study reports.

Exemestane (Aromasin), which belongs to a class of drugs called aromatase inhibitors, reduced the relative risk of breast cancer recurrence by nearly a third compared to tamoxifen. But, for exemestane to work in premenopausal women, the drug can only be given when ovarian function is being suppressed.

"For years, tamoxifen has been the standard hormone therapy for preventing breast cancer recurrences in young women with hormone-sensitive disease. These results confirm that exemestane with ovarian function suppression constitutes a valid alternative," study lead author Dr. Olivia Pagani, clinical director of the Breast Unit at the Oncology Institute of Southern Switzerland in Bellinzona, Switzerland, said in a prepared statement.

Findings from the study were scheduled to be presented Sunday at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago. The study was also published simultaneously in the New England Journal of Medicine. Funding for the study was provided by drug makers Pfizer and Ipsen, as well as the International Breast Cancer Study Group and the U.S. National Cancer Institute.

Aromatase inhibitors, such as exemestane, work by preventing other hormones from changing into estrogen, which is the female hormone that often fuels breast cancer growth.

By comparison, tamoxifen blocks estrogen from being used by cancer cells.

Tamoxifen has been the default standard of care for premenopausal women because aromatase inhibitors are not effective in women whose ovaries are functioning, said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.

"The amount of estrogen in their bodies is too great for it to have a beneficial function," Lichtenfeld said.

But doctors wondered whether aromatase inhibitors could be used to better protect young women against breast cancer if their ovary function was suppressed, essentially putting them through menopause and reducing their estrogen levels.

This study analyzed treatment outcomes of almost 4,700 breast cancer survivors who participated in two worldwide clinical trials aimed at answering that question.

The women, average age 43, all underwent treatment to stop their ovaries from functioning. Each chose one of three methods, Lichtenfeld said -- they could take medication to suppress ovary function, have their ovaries exposed to radiation, or have their ovaries surgically removed.

On top of ovary suppression, the women were randomly assigned to take either exemestane or tamoxifen to help prevent a recurrence of their breast cancer.

The cancer-free survival rate at five years ended up 91.1 percent in the exemestane group versus 87.3 percent in the tamoxifen group. That amounts to a 28 percent lower risk of subsequent invasive cancer, the researchers reported.

There was a 34 percent reduction in the risk of breast cancer recurrence in the exemestane group compared to the tamoxifen group. The study also found a 22 percent decrease in the risk of cancer spreading to other parts of the body.

"This definitely does show that using an aromatase inhibitor is clearly superior than using tamoxifen," said Dr. Larry Norton, deputy physician-in-chief for Breast Cancer Programs and medical director of the Evelyn H. Lauder Breast Center at Memorial Sloan Kettering Cancer Center in New York City. "It provides an important option for these patients."

Reported side effects were similar to those in previous studies that compared aromatase inhibitors and tamoxifen in postmenopausal women, and differed depending on the drug.

Despite the side effects, only 14 percent of the participants completely stopped the treatments early in the five-year trials. That's an adherence rate higher than what is seen in everyday practice, the researchers said. Previous studies suggest that many breast cancer survivors stop taking preventive hormone therapy before the recommended time.

Norton noted that younger breast cancer survivors might be more likely to take their post-treatment medications as directed if they had an alternative to tamoxifen, which is known to increase a woman's risk of endometrial cancer.

The five-year overall survival rates were high in both groups -- 95.9 percent in the exemestane group and 96.9 percent in the tamoxifen group. Longer follow-up is needed to get a better idea of the impact these two treatments will have on long-term survival, the researchers noted.

"Where the study stands right now, the women who got the Aromasin have had a delay in the recurrence of the disease, but they haven't necessarily had an improvement in survival," Lichtenfeld said.

Lichtenfeld and Norton said follow-up research needs to compare exemestane plus ovarian suppression directly with tamoxifen alone, since tamoxifen can be used without ovarian suppression to treat younger breast cancer survivors.

"My sense is in terms of practical implications, I suspect some physicians will change their treatment plans based on this, but I don't expect widespread change," Lichtenfeld said. "It's going to take more time, more understanding, and a comparison of the newer approach to the standard approach."

A second study, also scheduled to be presented on Sunday at the ASCO meeting, looked at using a combination of two treatments -- trastuzumab and lapatinib -- after surgery for a certain type of breast cancer. The study found that for breast cancers known as HER2 positive breast cancers, the drug lapatinib didn't make a significant difference in disease-free survival after four years.

In addition, the combination therapy led to an increased risk of side effects.

The researchers were surprised that lapatinib didn't add any benefit, but were encouraged that trastuzumab appears to work well on its own in women with early HER2 positive breast cancers after surgery.

More information

For more information on tamoxifen, visit the American Cancer Society.

SOURCES: Olivia Pagani, M.D., clinical director, Breast Unit, Oncology Institute of Southern Switzerland, Bellinzona; Len Lichtenfeld, M.D., deputy chief medical officer, American Cancer Society; Larry Norton, M.D., deputy physician-in-chief, Breast Cancer Programs and medical director, Evelyn H. Lauder Breast Center at Memorial Sloan Kettering Cancer Center; June 1, 2014 New England Journal of Medicine; June 1, 2014 presentation, American Society of Clinical Oncology conference, Chicago, Ill.

 
Related Items
Wellness Library
  Good News for Breast Cancer Detection and Care
  Solving the Breast Cancer Puzzle
  Reducing Your Risk for Breast Cancer
  Hope on the Horizon for Breast Cancer
SCC Videos
  Breast Biopsy
  Breast Cancer Screening
Content Type 156
  Breast Biopsy Podcast
  Breast Scan Podcast
Content Type 167
  BRCA
  CA 15-3
  CA 27-29
  Immunohistochemical Test for Estrogen and Progesterone Receptors
Nutritional Supplement Advisor
  Iodine
  Taurine
HealthInk Healthy Tips
  Breast Cancer and Smoking
Drug Reference
  Estradiol
  Fluoxymesterone
  Cyclophosphamide
  Testolactone
  Docetaxel
  Doxorubicin
  Capecitabine
  Trastuzumab
  Exemestane
  Fluorouracil, 5-FU
  Fulvestrant
  Goserelin
  Ifosfamide
  Nanoparticle Albumin-Bound Paclitaxel
  Lapatinib
  Ixabepilone
  Megestrol
  Anastrozole
  Methotrexate
  Methyltestosterone
  Mitoxantrone
  Paclitaxel
  Tamoxifen
  Testosterone
  Thiotepa
  Vinblastine
  Vincristine
  Epirubicin
  Letrozole
  Toremifene
Cancer Source
  Sex and Cancer: Questions for Your Doctor
  Breast Cancer—Understanding Genetic Testing
  What You Need to Know About Digital Mammography
  The Soy and Breast Cancer Controversy: Cause for Concern?
  The 'Chemobrain' Phenomenon in Breast Cancer
  MRIs for Breast Cancer Screening—Who Needs Them?
  Hormonal Therapy: Managing Side Effects in Women
  If You Are Having Hormonal Therapy
  What Is Breast Cancer?
  What to Know About Your Treatment Choices for Breast Cancer
  Ductal Carcinoma
  Statistics About Breast Cancer
  Can I Get Checked for Breast Cancer Before I Have Symptoms?
  What Can I Do if I Am at Risk for Breast Cancer?
  What Are the Symptoms of Breast Cancer?
  How Does My Doctor Know I Have Breast Cancer?
  Tests That Help Evaluate the Traits of Your Breast Cancer
  Understanding Your Grade and Stage of Breast Cancer
  What to Know About Surgery for Breast Cancer
  Breast Cancer: What Happens After Reconstructive Surgery
  Goal of Chemotherapy for Breast Cancer
  Do What You Can to Ease Side Effects of Treatment and Symptoms for Breast Cancer
  Finding Out You Have Breast Cancer
  What to Know About Combination Therapy for Breast Cancer
  How You Get Radiation for Breast Cancer
  What You Need to Know About Hormone Therapy for Breast Cancer
  Tips for Feeling Your Best During Treatment for Breast Cancer
  Taking Care of Your Incision After Breast Surgery
  How Your Doctor Uses Biopsies to Make Your Diagnosis of Breast Cancer
  Understanding Your Type of Breast Cancer
  What to Know About Inflammatory Breast Cancer (IBC)
  Can I Survive Breast Cancer? What Is My Prognosis?
  Am I at Risk for Breast Cancer?
  Myths About What Causes Breast Cancer
  Questions to Ask About Treatment for Breast Cancer
  What to Expect After Surgery for Breast Cancer
  What Happens During Radiation Therapy for Breast Cancer
  What to Expect After Radiation Treatment for Breast Cancer
  What Happens During Chemotherapy for Breast Cancer
  Making the Decision to Have Hormone Therapy for Breast Cancer
  What Happens During Hormone Therapy for Breast Cancer
  Ovarian Ablation as Hormone Therapy for Breast Cancer
  What to Expect After Taking Hormone Therapy Drugs for Breast Cancer
  What to Know About Targeted Therapy for Breast Cancer
  What Happens During Targeted Therapy for Breast Cancer
  Making the Decision to Have Breast Reconstruction After a Mastectomy for Breast Cancer
  When Breast Cancer Spreads to the Bones
  Exercising After Breast Cancer: Moving Toward Health
  Aromatase Inhibitors for Breast Cancer
Cancer FAQs
  Breast Cancer FAQ
Quizzes
  Breast Cancer Quiz
MRAs
  Breast Cancer Risk Assessment
Daily News Feed
  Mammogram Recalls Higher at Hospitals Than Private Practices: Study
  New Clues to Why Black Women Fare Worse Against Breast Cancer
  Family History of Cancer May Raise Risk for Other Types of Tumors
  Can Some Women Safely Skip Breast Surgery?
  Experts Call for Redefinition of 'Cancer'
  More Women Consider Gene Test After Angelina Jolie Mastectomy Revelation
  MRIs May Spur Unneeded Mastectomies in Older Women With Breast Cancer
  Breast-Feeding May Protect Some Women Against Breast Cancer
  Terms Docs Use Can Influence Patients' Cancer Choices
  Drinking Before First Pregnancy Raises Risk of Breast Cancer: Study
  MRI May Not Improve Outcomes for Early Form of Breast Cancer
  Most Women Don't Understand Their Breast Cancer Risk: Survey
  Most Breast Cancer Deaths Occur in Younger, Unscreened Women: Study
  Novel Drug Shows Promise for Early Stage Breast Cancer
  Researchers Focus on Likelihood of Breast Cancer Recurrence
  FDA Approves First 'Pre-Surgical' Drug for Breast Cancer
  Unfounded Fear Prompts Some Preventive Mastectomies: Study
  Report Sees Continued Advances in War Against Cancer
  First Generic Version of Xeloda Approved
  Tamoxifen's Mental Side Effects Are Real, Study Shows
  Shorter Radiation Course Appears Effective for Early Breast Cancer
  Women Vets May Need More Access to Breast Cancer Services
  Daily Tasks a Challenge for Many Older Breast Cancer Patients
  Stem Cells From Fat Might Improve Plastic Surgery
  Can Eating Peanut Butter Cut Breast Cancer Risk in Later Life?
  Blood Pressure Drug Might Boost Chemo Success, Mouse Study Suggests
  More Black Women in U.S. Diagnosed With Breast Cancer, Report Finds
  Perjeta Approved for Early Stage Breast Cancer
  New Analysis Confirms Hormone Therapy Won't Prevent Disease After Menopause
  Mexican Women's Breast Cancer Risk Tied to Breast-Feeding?
  Daily Walk May Cut Your Breast Cancer Risk
  Health Tip: Exercising After Breast Cancer
  Study Questions Use of Less-Invasive Lymph Node Surgery for Breast Cancer
  Experts Urge Routine Test for All Patients With Invasive Breast Cancer
  Breast Cancer Patients Have Unrelated Plastic Surgery After Reconstruction
  Could a Neck Injection Ease Tough-to-Bear Hot Flashes?
  Anesthesia Technique May Affect Survival After Breast Cancer Surgery: Study
  Being Web-Savvy Tied to Better Health in Seniors: Study
  'Body Clock' May Explain Why Some Body Parts Age Faster Than Others
  After Breast Cancer Surgery, Patient Assistance Programs Can Help
  Breast Cancer Diagnosed at Later Stage in Rural Patients: Study
  Hormone Levels May Help Predict Breast Cancer Risk, Study Finds
  Health Tip: Performing a Breast Self-Exam
  Tests May Someday Show Which Breast, Prostate Cancers Will Turn Aggressive
  Radiation for Breast Cancer May Raise Heart Risks: Study
  Some Women Cite Personal Growth After Breast Cancer Diagnosis
  Poorer Women Delay Examination of Breast Lumps, Study Suggests
  Exercise May Help Breast Cancer Survivors Battle Bone Loss
  Many Women Suffer Persistent Pain After Mastectomy
  'One-Stop' Radiation Treatment Might Offer Breast Cancer Care Alternative
  Most Men With Breast Cancer Undergo Mastectomy, Study Finds
  Study Compares Treatments for Arm Swelling Due to Breast Cancer
  Use of Breast MRIs Way Up, Studies Find
  Breast-Density Changes May Be Tied to Cancer Risk: Study
  Even When Breast Cancer Gene Test Is Negative, Risk Can Persist: Study
  Frequent Mammograms Tied to Lower Risk of Breast Cancer Spread
  Money Problems Can Compromise Breast Cancer Care
  Obesity, Smoking Might Threaten Implants After Mastectomy
  Drug Arimidex Cuts Risk for Breast Cancer in Older, High-Risk Women: Study
  Exercise Might Ease Joint Pain Caused by Breast Cancer Drugs
  Exercise Linked to Lower Breast Cancer Risk in Black Women
  Bigger Breasts, Lack of Exercise Tied to Breast Cancer Mortality
  Bones Benefit From Exercise After Breast Cancer, Study Finds
  New Look at Past Studies Highlights Importance of Mammograms
  New Treatment for Aggressive Breast Cancer Shows Some Promise
  Drug May Help Slow Advanced Breast Cancer
  Chemo for Advanced Breast Cancer Might Be Enough
  2 Pre-Surgery Drug Treatments Show Promise Against Aggressive Breast Cancer
  FDA Warns Against Nipple Test for Breast Cancer Screening
  U.S. Cancer Death Rates Continue to Decline: Report
  80 Percent of Cancer Docs Have Faced Drug Shortages: Survey
  Angelina Jolie's Story Didn't Boost Knowledge of Breast Cancer Risks: Study
  Acupuncture No Better Than 'Sham' Version in Breast-Cancer Drug Study
  Only High-Risk Women Need Breast Cancer Gene Test: Experts
  Troubled Launch of 'Obamacare' Tops Health News for 2013
  Many Women Still Have Pain One Year After Breast Cancer Surgery
  U.S. Cancer Deaths Decline Again: Report
  Progress Against Cancer May Be Greater Than Thought
  'Sleep Hormone' Tied to Possible Lower Prostate Cancer Risk
  Yoga May Reduce Fatigue, Inflammation in Breast Cancer Survivors
  Doctors May Need to Revise How They Evaluate Breast Biopsy Results
  Running Might Beat Walking for Breast Cancer Survivors
  Expanded DNA Testing Might Allow Personalized Breast Cancer Treatment
  Gene Exam Might Predict Breast Cancer Progression
  Annual Mammograms Don't Reduce Breast Cancer Deaths, Study Contends
  Double Mastectomy May Benefit Some Women With Inherited Breast Cancer
  More Breast Cancer Patients Choosing Reconstructive Surgery, Study Finds
  Avastin Shows Mixed Results Against Different Cancers
  Ovarian Cancer Gene May Point to Early Removal of Ovaries: Study
  Necks, Butts Growth Areas for U.S. Plastic Surgeons
  Yoga May Help Breast Cancer Patients During Radiation Therapy
  Targeted Radiation Might Help Fight Advanced Breast Cancer: Study
  Whole-Genome Scans Not Quite Ready for Widespread Use: Study
  Study Supports Radiation When Breast Cancer Spreads to Few Lymph Nodes
  Daily Exercise Lowers Breast Cancer Risk: Study
  New Guidelines Might Limit Need for Lymph Node Removal for Breast Cancer
  Routine Mammograms Found Not Helpful for Most Women Over 70
  Many Breast Cancer Survivors Suffer Financially, Study Finds
  Slight Drop in Rate of Advanced Cancers, CDC Says
  Fertility Drugs May Not Raise Breast Cancer Risk: Study
  New Review Suggests Benefits of Annual Mammograms Are Overstated
  Experimental Breast Cancer Drug Seems Safe, Effective for Advanced Disease
  Vegetables in Childhood May Benefit Breast Health
  Could Daughter's Cancer Risk Be Affected by Father's Age at Birth?
  High-Fat Diet May Boost Breast Cancer Risk
  Cheaper 'Gene Panel' Screening May Reveal Cancer Risks
  Blood Test Aims to Predict Breast Cancer's Return
  So-Called 'Apple Shape' Not a Risk Factor for Breast Cancer: Study
  False-Positive Mammograms Don't Deter Women From Future Screening: Study
  Joblessness an Unwanted Side Effect of Chemo for Breast Cancer
  Radiation May Equal Surgery, With Easier Recovery, for Cancerous Lymph Nodes
  'Freezing' Technique May Work for Some Women With Early Breast Cancer
  Ultrasound of Lymph Nodes No Less Accurate for Obese Women, Study Says
  Lung Cancer Not on Many Women's Radar: Survey
  Tough-to-Treat Breast Cancer Nearly Twice as Common in Black Women: Study
  Obesity May Raise Breast Cancer Death Risk for Some Women
  Could a Blood Test Predict Breast Cancer's Return?
  Surgery Isn't Only Option for Women With Ovarian Cancer Genes
  Double Mastectomy Often Not Needed, Study Finds
  New Guidelines Recommend Longer Tamoxifen Treatment
  Memory Problems After Chemo Linked to Brain Changes
  Drug May Lower Odds of Early Menopause in Breast Cancer Patients
  Some Breast Cancer Patients May Get Drug-Linked Heart Failure: Study
  Certain Breast Cancer Patients May Need Little Treatment After Tumor Removal
  Medicaid Patients Get Worse Cancer Care, Studies Contend
  Sophisticated Chest Scans May Raise Children's Lifetime Cancer Risk
  Many Women With Breast Cancer Get Too Little Exercise
  Breast Cancer Drug Herceptin Linked to Risk of Heart Problems: Study
  Moles May Be Harbinger of Higher Breast Cancer Risk
  Red Meat May Raise Breast Cancer Risk, Study Suggests
  Tumor-Targeting Agent Attaches to Cancer Cells: Study
  Breast Cancer Surgery Rates Vary Greatly in Canada
  Women With Breast Cancer Genes More Likely to Choose Extensive Surgery
  Older Breast Cancer Patients Do Follow Drug Therapy: Study
  MRIs Plus Mammograms Best for High-Risk Women, Study Finds
  Mammography Cuts Breast Cancer Deaths by 28 Percent: Study
  3D Mammograms May Improve Breast Cancer Screening
  Mammography Costs Soar for Seniors, But Detection Rates the Same: Study
  Men Develop Breast Cancer, Too
  'Generally Reassuring' Findings on Fertility Drugs, Women's Cancers
  Cholesterol Levels May Be Linked to Breast Cancer Risk
  Breast Cancer Drug Aromasin May Be Option for Some Premenopausal Women
  Removing Healthy Breast of Little Benefit to Breast Cancer Patients: Study
Adult Diseases and Conditions
  Breast Cancer Prevention Trial (BCPT)
  Chemotherapy for Breast Cancer Treatment
  About Clinical Trials: Information from the National Cancer Institute
  How Is Breast Cancer Diagnosed?
  General Information About Breast Cancer
  Other Treatments for Breast Cancer
  National Surgical Adjuvant Breast and Bowel Project (NSABP)
  Post-Mastectomy
  Radiation Therapy for Breast Cancer Treatment
  Risk Factors for Breast Cancer
  Signs and Symptoms of Breast Cancer
  Stages of Breast Cancer
  Study of Tamoxifen and Raloxifene (STAR)
  Breast Cancer Statistics
  About Taxol
  Breast Health: Three-Step Plan for Preventive Care
  Treatments for Breast Cancer
  Hereditary Breast Ovarian Cancer Syndrome (BRCA1/BRCA2)
  Genetics of Breast Cancer
  Breast Cancer Overview
Newsletters
  Should You Consider Preventive Drugs for Breast Cancer?
  Should You Be Tested for the Breast Cancer Gene?
Test and Procedures
  Breast Biopsy