Back June 23, 2016

Beyond 5 years? What’s next? 4 Questions to Discuss with Your Doctor About Continuing Anti-Estrogen Therapy

The prognosis for early-stage, estrogen receptor-positive (ER+) breast cancer is generally favorable. Most women are disease-free after 5 years of anti-estrogen therapy. While that’s certainly reason for optimism, there is still a chance your cancer can return. In fact, more than half of recurrences of ER+ breast cancer occur after 5 years of treatment.

If you’re approaching your 5-year mark or even if you’re beyond it, learning about your personal risk of cancer recurrence and options for continuing anti-estrogen treatment can help you and your doctor make more informed treatment decisions about the next phase of your cancer journey. To get started, here are 4 questions to help navigate the conversation with your physician to ensure you’re embarking on the right treatment plan for you.

1. Is there a way to find out my personal risk for the cancer coming back after 5 years?

While each patient’s breast cancer is unique and has its own biological factors that help determine the potential for recurrence, there are tools available to help determine your personal risk of cancer coming back.  If you are an ER+, early-stage breast cancer patient, it is important for you to stay informed about the options available to you. Do your research and come prepared to talk to your doctor about tools which can help determine your risk of cancer recurrence.

2. Can the cancer be prevented from coming back?

Cancer recurrence is different for every breast cancer patient. Surviving for 5 years after diagnosis and treatment is generally the yardstick for measuring cancer treatment success – but ER+ breast cancer is not just a 5-year disease.  To prevent ER+ breast cancer from returning, some patients who have completed their initial 5 years of treatment may be prescribed anti-estrogen therapy (typically tamoxifen or an aromatase inhibitor, depending on menopausal status) for an additional 5 years

3. How do I know whether or not an additional 5 years of anti-estrogen therapy is likely to help me?

While extending anti-estrogen therapy may help 3-5% of women, it may not be for everyone. Women making this decision should keep in mind that it should be based their own personal breast cancer treatment journey. Consult with your doctor to discuss your options and a new genomic test  that can help asses if continuing anti-estrogen therapy will likely be beneficial for you.

4. Are there any long-term health concerns or side effects from taking anti-estrogen medicines for an extended period of time?

The anti-estrogen therapies (e.g., tamoxifen, aromatase inhibitors (Femara, Arimidex, etc.) have well known potential side effects. These can range from day-to-day tolerability issues like hot flashes, joint and muscle pain, and sexual dysfunction, to potential long-term safety concerns such as heart disease, endometrial cancer, and fractures. If you are considering extending anti-estrogen therapy beyond the 5-year mark, ask your doctor about your personal risk of cancer recurrence and available therapeutic options. Understanding your personal risk of recurrence and whether or not extended therapy is likely to benefit you will help you and your physician decide whether 5 more years of anti-estrogen therapy is right for you.