No added survival benefit found in older breast cancer patients who take pills beyond five years

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MERRIAM, Kan. -- Most women who've had breast cancer take anti-estrogen drugs. Post-menopausal women typically take them for five years. Researchers wondered if women should take them longer. They found it doesn't provide more benefit in terms of survival.

Becca Bell is director of oncology services for Shawnee Mission Health. A year ago, she also became a patient there when she was diagnosed with breast cancer.

"My first reaction was actually that it was inconvenient, that's what I felt, because I knew at least a year of my life was going to change," said Bell.

After surgery, chemotherapy and radiation, Bell went on a daily anti-estrogen pill to increase the chances of a cure.

Post-menopausal breast cancer patients typically take a pill for five years. But because about half of their cancer recurrences happen after five years, researchers wanted to know if those women should extend treatment.

They looked at nearly 4,000 women who took either the anti-estrogen pill Letrozole or a placebo. On average, they took it for two more years.

"What they found is there's no benefit in overall survival which is huge," said Dr. Tracy Miles, an oncologist with Shawnee Mission Health.

Dr. Miles said there was no added survival benefit although it did lower the chances of recurrence by 29 percent. But there was a downside to extended treatment. Those women were slightly more likely to have heart attacks or strokes.

"We've answered the question -- how long for postmenopausal women and that's five years," said Dr. Miles.

Although researchers say women whose cancers have certain high-risk features may want to extend treatment.

For Bell and other pre-menopausal women, as long as 10 years on the drugs is recommended. That doesn't change with this study.

"But I do have friends that are in their five-year window that were post-menopausal, so for them, it's great news," she said.

The study was presented today at the San Antonio Breast Cancer Symposium.