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| Risk of breast cancer's return looms for 20 years: study | |
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| Tweet Topic Started: 9 Nov 2017, 02:29 AM (59 Views) | |
| skibboy | 9 Nov 2017, 02:29 AM Post #1 |
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09 November 2017 Risk of breast cancer's return looms for 20 years: study ![]() © AFP/File | Researchers found a "steady" risk of tumors recurring over the next 15 years, up to 20 years after the initial diagnosis MIAMI (AFP) - Women who are treated for a kind of breast cancer that is fueled by the hormone estrogen face a substantial risk of the cancer returning, even 20 years later, researchers said Wednesday. The risk is highest in women whose original tumors were large and affected four or more lymph nodes, said the report in the New England Journal of Medicine. Researchers analyzed data from 88 clinical trials involving nearly 63,000 women with estrogen-receptor (ER) positive breast cancer, one of the most common types. Patients in the study all received endocrine therapy -- such as tamoxifen which is the standard of care to cut the risk of cancer recurrence -- for five years and were free of cancer when they stopped therapy. But researchers found a "steady" risk of tumors recurring over the next 15 years, up to 20 years after the initial diagnosis. "Even though these women remained free of recurrence in the first five years, the risk of having their cancer recur elsewhere -- for example in the bone, liver or lung -- from years five to 20 remained constant," said senior author Daniel Hayes, professor of breast cancer research at the University of Michigan Comprehensive Cancer Center. Women whose original tumors were large enough to have spread to four or more lymph nodes had a 40 percent risk of a cancer recurrence over the next 15 years. For women with small, low-grade cancers and no spread to the lymph nodes, the risk of cancer recurring was 10 percent in 15 years. "It is remarkable that breast cancer can remain dormant for so long and then spread many years later with this risk remaining the same year after year and still strongly related to the size of the original cancer and whether it had spread to the nodes," said lead author Hongchao Pan, from the University of Oxford. The findings raise questions about the current practice of treating women with tamoxifen or aromatase inhibitors for five years after the tumor is removed, in order to reduce the risk of a recurrence. Some experts believe the treatment should be extended to 10 years. Side effects can include hot flashes, vaginal dryness, osteoporosis and joint pain. Ultimately, the decision is up to a woman and her doctor, said Hayes. "These data can be used by patients and their health care providers as they consider whether to continue taking anti-estrogen therapy beyond five years, weighed against side effects and toxicity of the therapies," he said. Treatments for breast cancer have improved in recent years, so the estimated risks of recurrence may be on the high side, said co-lead author Richard Gray, of the University of Oxford. "To assess 20-year risks, we had to study women who received their breast cancer diagnosis many years ago," said Gray. "We know that treatments have improved since then, so recurrence rates will be somewhat lower for women who were diagnosed more recently." Source: .com
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| skibboy | 10 Nov 2017, 01:44 AM Post #2 |
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Breast cancer 'can return 15 years after treatment ends' 9 November 2017 ![]() Breast cancer can resurface after remaining dormant for 15 years following successful treatment, a study has found. Women with large tumours and cancer that had spread to the lymph nodes had the highest 40% risk of it coming back. Researchers writing in the New England Journal of Medicine said extending treatment with hormone therapy could reduce the risk of it recurring. Scientists analysed the progress of 63,000 women for 20 years. All had the most common form of breast cancer. This is a type fuelled by the hormone oestrogen which can stimulate cancer cells to grow and divide. Every patient received treatments such as tamoxifen or aromatase inhibitors which block the effects of oestrogen or shut off the hormone's supply. Although after five years of treatment their cancers had gone, over the next 15 years a steady number of women found that their cancer spread throughout their body - some up to 20 years after diagnosis. Women who originally had large tumours and cancer that had spread to four or more lymph nodes were at highest risk of the cancer returning the next 15 years, the study said. Women with small, low-grade cancers and no spread to the lymph nodes had a much lower 10% risk of cancer spread over that time. 'Remarkable' Lead researcher Dr Hongchao Pan, from University of Oxford, said: "It is remarkable that breast cancer can remain dormant for so long and then spread many years later, with this risk remaining the same year after year and still strongly related to the size of the original cancer and whether it had spread to the (lymph) nodes." Doctors have long known that five years of tamoxifen reduces the risk of recurrence by about a third in the five years after stopping treatment. Recent research has suggested that extending hormone therapy to 10 years may be more effective at preventing breast cancer recurrence and death. ![]() Breast cancer cells are stimulated to grow and divide by the hormone oestrogen Aromatase inhibitors, which only work for post-menopausal women, are believed to be even more effective. But there are side effects with hormone treatments which can affect patients' quality of life and cause them to stop taking the pills. These include menopausal symptoms, osteporosis, joint pain and carpal tunnel syndrome. Prof Arnie Purushotham, senior clinical adviser at Cancer Research UK, which funded the study, said that since the research began, new drugs had been used to treat breast cancer and those worked in different ways to tamoxifen. He said: "It's vital that work continues to better predict which cancers might return. "We also need to know what the difference for women might be in taking hormone therapies for 10 years instead of five, the side effects and how this affects patients' quality of life." Sally Greenbook, from charity Breast Cancer Now, said it was essential that women discussed any changes in treatment with their doctor. "We would urge all women who have had treatment for breast cancer not to be alarmed, but to ensure they are aware of the signs of recurrence and of metastatic breast cancer, and to speak to their GP or breast care team if they have any concerns." Source: .com
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3:25 PM Jul 11