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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 cancer-related genes.

"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 back."

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.

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