Breast Cancer Recurrence: What You Should Know
When women quit breast cancer treatment early, they take a big risk.
Importance of Sticking With the Plan continued...
In recent years, gene-based tests have allowed oncologists to also examine
the "gene signature" of a tumor, which indicates recurrence risk. The
newest such test is MammaPrint, which analyzes breast tumors for 70
"We can pretty precisely predict 10-year probability of recurrence with
gene profiles," Pegram tells WebMD. "These tests have revolutionized
treatment planning for breast cancer patients."
Specific genes in the cancer cells tell oncologists how the tumor will grow,
how likely the cancer is to recur, and generally how the tumor will behave.
With this information, oncologists can shape treatment -- whether chemotherapy
is necessary or not, and how aggressive it should be, he explains.
In this new era of breast cancer medicine, drugs and treatments can directly
target specific types of cancer cells. Some drugs interfere with specific
molecules involved in tumor growth. Others slow the growth of breast cancer
cells that are fueled by the hormone estrogen. Others target the blood vessels
that feed cancer cells.
That's why oncologists emphasize the need to stick with the treatment plan,
Vogel explains. "All of this is about avoiding recurrence. The side effects
of the drugs are a whole lot better than having breast cancer come
Toughing Out the Side Effects
Indeed, the side effects of breast cancer medications can be serious. On the
telephone hotline at Living Beyond Breast Cancer (a not-for-profit agency),
side effects are a common complaint. "We hear it all the time, women
wanting to stop the medications because of side effects," says Caplan, who
oversees the hotline.
"Doctors need to reinforce the fact that chemotherapy and other targeted
therapies help to kill microscopic cancer cells, to prevent a recurrence,"
Caplan tells WebMD. "If you quit treatment, you don't know you've given
yourself the full benefit. Talking about it will help women who are struggling
to stay the course."
In recent years, studies have found that women are quitting two types of
hormone therapy drugs -- aromatase inhibitors (Femara, Aromasin and Arimidex)
and the anti-estrogen drug
tamoxifen -- because of side effects.
One study suggested that nearly one-half of women taking aromatase
inhibitors quit because of severe muscle aches and joint pains. The drugs block
an enzyme the body uses to make estrogen, which fuels some breast cancers. They
can substantially slash the risk of recurrence if taken for the prescribed
length of time.
Another study showed that, although a five-year course of tamoxifen is
typically recommended, some
women took the drug for less than three years. One in 10 women filled 70% or
fewer of their tamoxifen prescriptions -- which increased their risk of death
by 16%. Women were not asked why they stopped taking tamoxifen, but it is known
to cause difficult hot flashes, researchers note.