Saturday, October 28, 2006

How much risk reduction is associated with hormone therapy?

Tamoxifen given for five years to women with hormone-responsive breast cancer lowers the risk of recurrence by 40 percent per year, and the overall benefit will be close to a one-third reduction in risk. There is no consistent evidence of benefit with tamoxifen beyond five years. In addition, the risk of developing uterine cancer increases with more exposure, so after five years you get no additional benefit, but you keep adding risk.

The last few years have given us new options in adjuvant hormone therapy for postmenopausal women. It now looks increasingly like substituting or switching to or following that tamoxifen with an aromatase inhibitor further improves outcome.

We have three large randomized trials as of May of 2004, all of which show the same thing: The risk of a recurrence of breast cancer in the breast or a recurrence of breast cancer outside the breast is more greatly reduced when a woman is on a aromatase inhibitor compared to tamoxifen.

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