Characteristics Of The Included Trials
Two hundred forty-eight articles were initially identified through searching the PubMed, Embase and abstracts of International Meeting. One hundred seventy-one articles were excluded by checking the titles and abstracts, and 65 articles were excluded after reading the full text. Finally, 12 trials involving 30,848 cases were included in the meta-analysis. The selection flow chart is shown in Fig. , and the design of extended endocrine treatment in all trials is shown in Fig. . The characteristics of the included trials are shown in Table . The analysis of Cochrane risk-of-bias showed that the methodological quality of all trials was relatively satisfied and fair.
Inclusion of the studies and design of extended endocrine treatments. a 12 articles were included in quantitative analysis , b The design of extended adjuvant endocrine treatment
Ten Years Of Tamoxifen Reduces Breast Cancer Recurrences Improves Survival
For some women with breast cancer, taking adjuvanttamoxifen for 10 years after primary treatment leads to a greater reduction in breast cancer recurrences and deaths than taking the drug for only 5 years, according to the results of a large international clinical trial.
Nearly 7,000 women with early-stage, estrogen receptor-positive breast cancer were enrolled in the trial between 1996 and 2005. After taking tamoxifen for 5 years, participants were randomly assigned to continue taking tamoxifen for another 5 years or to stop taking it.
From 5 to 9 years after the women began tamoxifen therapy, there was little difference in outcomes between the two treatment groups. This finding is consistent with those from other trials of adjuvant tamoxifen therapy, which showed that 5 years of tamoxifen can substantially reduce the risk of the cancer returning and of cancer death in the next few years, what one of the trial investigators, Richard Gray, MSc, of Oxford University, UK, called a “carryover effect.”
Overall, from 5 to 14 years after participants began tamoxifen treatment, the risk of the cancer returning and the risk of dying from breast cancer were lower in women who took tamoxifen for 10 years, compared with those who took it for 5 years.
- Posted:March 20, 2013
Will I Have Any Permanent Damage After Using Arimidex
Its not likely that you will. In fact, side effects of Arimidex usually go away once youve stopped taking the drug.
However, Arimidex can weaken your bones while youre taking it. And some women can develop osteoporosis from this. You also have an increased risk of breaking a bone with Arimidex treatment. But one study found that after stopping Arimidex, the risk of breaking a bone was no longer increased.
If youre concerned about long-term side effects or permanent damage caused by Arimidex, talk with your doctor. They can discuss with you the risks and benefits of using this drug.
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Update On Extended Aromatase Inhibitor Therapy
- In women with postmenopausal hormone receptorpositive early breast cancer who tolerated 5 years of aromatase inhibitor therapy after tamoxifen, an additional 5 years of letrozole improved disease-free survival by 34% and reduced the risk of contralateral breast cancer by 58%.
- These results should be interpreted with caution and probably are relevant mainly for women at high risk of recurrence.
Most toxicities were similar in the two groups. Letrozole-treated women had more frequent reports of bone pain, bone fracture, and new-onset osteoporosis. There were few treatment-related discontinuations .
Bone fracture occurred in 133 letrozole-treated women and 88 placeb-treated women. The majority of women who sustained a bone fracture during the study were taking bone-protective agents such as bisphosphates, calcium supplements, and vitamin D supplements. These differences in bone-related effects are a consideration when contemplating longer-term aromatase inhibitor therapy, Dr. Goss noted. He added that further bone analyses would be conducted, in order to better predict which patients are specifically vulnerable to clinical fractures.
It is very reassuring for women who want a longer duration of aromatase inhibitor therapy that they can expect a preserved quality of life, said , who reported quality-of-life data from MA.17R at the press conference at the ASCO Annual Meeting.
Disclosure: Drs. Goss and Lemieux reported no potential conflicts of interest.
What Type Of Meds Will I Need For Breast Cancer
If you have a lumpectomy or mastectomy, before or after surgery you also may need medication. Systemic therapies given before surgery are called neoadjuvant therapy, and their goal is to shrink or stop the tumor from growing.
Those given after surgery are called adjuvant therapy and they aim to prevent the tumor from re-emerging. Unfortunately, tumors can adapt to medications and stop respondingin those cases a doctor may switch you to a new drug or combination of drugs.
There are four main types of medication used in treating breast cancer: chemotherapy, hormone therapy, targeted therapy, and immunotherapy.
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Taking Anastrozole With Other Drugs
If youre taking any other prescribed or over-the-counter medicines, check with your treatment team or pharmacist if you can take these with anastrozole.
Do not take other drugs containing oestrogen, such as hormone replacement therapy , while youre taking anastrozole as this may interfere with its effectiveness.
Talk to your specialist, pharmacist or GP about any complementary therapies, herbal remedies or supplements you want to use before you start using them.
How Targeted Therapy Works
Targeted therapies are created to attack specific parts of cancer cells to prevent cancer growth or to shrink existing tumors.
Each type of targeted therapy works a little differently, but all tend to interfere with the ability of cancer cells to grow, divide, repair, and communicate with other cells.
Here are some of the common types of targeted therapy:
- Monoclonal antibodies. These medications are often combined with toxins, chemotherapy drugs, and radiation. They attach to targets on the surface of cancer cells and deliver these substances, causing cancer cells to die without harming healthy cells.
- Small molecule inhibitors. These drugs generally target and inhibit specific pathways and processes that cause cancer cells to proliferate. They must be small enough to be able to enter the cell and interfere with proteins on both the inside and outside of the cell.
- Angiogenesis inhibitors. These drugs inhibit the formation of new blood vessels, which fuel the growth of cancer cells.
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What Is Hormone Receptor
Breast cancer tumors that are hormone receptor-positive need the hormones estrogen or progesterone to grow. Approximately 75% of breast cancers are hormone-positive in post-menopausal patients. Your healthcare provider will perform a biopsy and laboratory testing to determine the cancer type and most effective treatment.
What Are The Side Effects Of Hormone Therapy
The side effects of hormone therapy depend largely on the specific drug or the type of treatment . The benefits and harms of taking hormone therapy should be carefully weighed for each person. A common switching strategy used for adjuvant therapy, in which patients take tamoxifen for 2 or 3 years, followed by an aromatase inhibitor for 2 or 3 years, may yield the best balance of benefits and harms of these two types of hormone therapy .
Less common but serious side effects of hormone therapy drugs are listed below.
- breathing problems, including painful breathing, shortness of breath, and cough
- loss of appetite
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Why Is This Medication Prescribed
Anastrozole is used with other treatments, such as surgery or radiation, to treat early breast cancer in women who have experienced menopause . This medication is also used in women, who have experienced menopause, as a first treatment of breast cancer that has spread within the breast or to other areas of the body. This medication is also used to treat breast cancer in women whose breast cancer has worsened after taking tamoxifen . Anastrozole is in a class of medications called nonsteroidal aromatase inhibitors. It works by decreasing the amount of estrogen the body makes. This can slow or stop the growth of many types of breast cancer cells that need estrogen to grow.
Is Tamoxifen Right For You
Tamoxifen is used to treat pre- and post-menopausal women and men diagnosed with either early-stage or advanced-stage, hormone receptor-positive breast cancer.
Tamoxifen is also used after surgery to reduce the risk of invasive breast cancer in women who have been diagnosed with hormone receptor-positive DCIS.
Tamoxifen is also used to reduce breast cancer risk in women with a higher-than-average risk of the disease who havent been diagnosed.
You should not take tamoxifen if you have a history of blood clots or take blood-thinning medicine. Tamoxifen increases the risk of blood clots.
You should not take tamoxifen if you are breastfeeding, pregnant, trying to get pregnant, or if there is any chance that you could be pregnant. Tamoxifen may cause damage to developing embryos. You should use an effective non-hormonal type of birth control while you are taking tamoxifen. Ask your doctor which type of non-hormonal birth control would be best for you. You should use the birth control for at least two months after your last dose of tamoxifen.
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Can Arimidex Be Crushed Split Or Chewed
No, you shouldnt crush, split, or chew Arimidex tablets. Instead, you should swallow them whole. If you have trouble swallowing pills, talk with your doctor or pharmacist.
When you get Arimidex from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.
The expiration date helps guarantee that the medication is effective during this time. The of the Food and Drug Administration is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.
What To Do In Case Of Overdose
If you think youve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.
You should take Arimidex according to your doctors or healthcare providers instructions.
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If Cancer Comes Back Or Has Spread
AIs, tamoxifen, and fulvestrant can be used to treat more advanced hormone-positive breast cancers, especially in post-menopausal women. They are often continued for as long as they are helpful. Pre-menopausal women might be offered tamoxifen alone or an AI in combination with an LHRH agonist for advanced disease.
Can Hormone Therapy Be Used To Prevent Breast Cancer
Yes. Most breast cancers are ER positive, and clinical trials have tested whether hormone therapy can be used to prevent breast cancer in women who are at increased risk of developing the disease.
A large NCI-sponsored randomized clinical trial called the Breast Cancer Prevention Trial found that tamoxifen, taken for 5 years, reduces the risk of developing invasive breast cancer by about 50% in postmenopausal women who were at increased risk . Long-term follow-up of another randomized trial, the International Breast Cancer Intervention Study I, found that 5 years of tamoxifen treatment reduces the incidence of breast cancer for at least 20 years . A subsequent large randomized trial, the Study of Tamoxifen and Raloxifene, which was also sponsored by NCI, found that 5 years of raloxifene reduces breast cancer risk in such women by about 38% .
As a result of these trials, both tamoxifen and raloxifene have been approved by the FDA to reduce the risk of developing breast cancer in women at high risk of the disease. Tamoxifen is approved for this use regardless of menopausal status. Raloxifene is approved for use only in postmenopausal women.
If You Cant Have Surgery
Surgery is the main treatment for breast cancer, but some women have health problems that mean they cant have surgery. Some women choose not to have surgery.
In this case, if your breast cancer is oestrogen receptor positive, your doctor might recommend hormone therapy. This treatment won’t get rid of the cancer but can stop it growing or shrink it.
The treatment can often control the cancer for some time. Your doctor might change you to a different type of hormone treatment if your cancer starts growing again.
Hormone Therapy For Breast Cancer
Some types of breast cancer are affected by hormones, like estrogen and progesterone. The breast cancer cells have receptors that attach to estrogen and progesterone, which helps them grow. Treatments that stop these hormones from attaching to these receptors are called hormone or endocrine therapy.
Hormone therapy can reach cancer cells almost anywhere in the body and not just in the breast. It’s recommended for women with tumors that are hormone receptor-positive. It does not help women whose tumors don’t have hormone receptors .
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Targeted Therapy Vs Chemotherapy
Chemotherapy is a type of cancer treatment that works by killing fast-growing cells in your body to help prevent the growth and spread of cancer cells. It can be given as an oral medication or administered through an IV.
But because chemotherapy can kill both healthy and cancerous cells in your body, it can cause many side effects.
On the other hand, targeted therapy is a treatment that attacks cancer cells specifically by interfering with certain pathways that control their growth.
Unlike chemotherapy, targeted therapy is designed to only affect cancer cells, meaning that its less likely to harm the normal, healthy cells in your body. But targeted therapy pills do have side effects as well.
Furthermore, while chemotherapy kills off cancer cells that have already been produced, targeted therapy also works by preventing cancer cells from multiplying and spreading.
Targeted therapy can be administered orally or through an IV for the treatment of breast cancer. Its often used alone or in combination with other cancer treatments, including chemotherapy.
Targeted Therapy Medications More > >
|GENERIC NAME everolimus|
Afinitor is a kinase inhibitor approved for the treatment of hormone receptor-positive, HER2-negative advanced breast cancer in previously treated postmenopausal women, as well as for advanced kidney cancer and advanced or metastatic neuroendocrine tumors of the lung, pancreas, and gastrointestinal tract.
|GENERIC NAME fam-trastuzumab deruxtecan-nxki|
Enhertu is a HER2 antibody combined with a chemotherapy drug. It is approved for previously treated people with inoperable or metastatic HER2-positive breast cancer and for people with locally advanced or metastatic HER2-positive stomach or gastroesophageal junction cancer.
|GENERIC NAME trastuzumab|
Herceptin is a HER2 inhibitor approved for adjuvant therapy of early breast cancer and treatment of metastatic breast cancer, stomach cancer and esophageal cancer that overexpresses human epidermal growth factor receptor 2.
|GENERIC NAME palbociclib|
Ibrance is a CDK4/6 kinase inhibitor approved for the treatment of hormone receptor-positive, HER2-negative advanced or metastatic breast cancer in combination with hormone therapy.
|GENERIC NAME ado-trastuzumab emtansine|
Kadcyla is a HER2 inhibitor combined with a chemotherapy drug. It is approved for people with HER2-positive metastatic breast cancer who were previously treated with Herceptin and chemotherapy and for adjuvant therapy for early breast cancer.
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Assessment Of Risk For Breast Cancer
Various methods are available to identif y women at increased risk for breast cancer, including formal clinical risk assessment tools or assessing breast cancer risk factors without using a formal tool.
Numerous risk assessment tools, such as the National Cancer Institute Breast Cancer Risk Assessment Tool,5 estimate a womans risk of developing breast cancer over the next 5 years. There is no single cutoff for defining increased risk for all women. Women at greater risk, such as those with at least a 3% risk for breast cancer in the next 5 years, are likely to derive more benefit than harm from risk-reducing medications6 and should be offered these medications if their risk of harms is low. Some women at lower risk for breast cancer have also been included in trials documenting reduced risk for breast cancer when taking tamoxifen, raloxifene, or aromatase inhibitors.3,4 However, when balancing the harms associated with these medications, the net benefit will be lower among women at lower risk.
Women not at increased risk for breast cancer, such as women younger than 60 years with no additional risk factors for breast cancer, or women with a low 5-year risk of breast cancer should not be routinely offered medications to reduce risk of breast cancer because the risk of harms from these medications likely outweighs their potential benefit.
Surgery To Stop The Ovaries From Working
This is also a type of ovarian ablation. You might choose to have an operation to remove your ovaries instead of having drug treatment to stop them working. You have this operation as keyhole surgery. It is called laparoscopic oophorectomy and you have it under general anaesthetic . You usually stay in hospital overnight.
The surgeon makes a number of small cuts into your tummy . They put a long bendy tube called a laparoscope into one of the cuts. The laparoscope connects to a video screen.
The surgeon puts small instruments through the other cuts to carry out the operation and remove the ovaries. They close the cuts with stitches and cover them with small dressings.
Removing your ovaries causes you to have a sudden menopause. The symptoms include hot flushes, sweating and mood swings.
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