Breast
cancer recurrence in the second decade after diagnosis
Interview
with Neil Love, MD Breast Cancer Update for Medical Oncologists,
Program 6 2000
Play
Audio Below:
You
can get quite a lot of recurrence of the original primary more than 10
years after diagnosis. It’s a disease that can lay quiescent for
five, 10, 15 years, and then come back. So, yes, there’s some second
primaries in that second decade, but there’s also some recurrences
of the original primary. Rather curious. It’s a very weird disease.
There’s no other cancer like it — prostate is a bit like it
— but really it’s not like most other cancers. Most cancers,
if you’re really free of disease five years down the line, you’re
probably cured. Breast cancer can come back later, and we’ve really
got to be thinking of treatment strategies that provide protection not
only in the first decade after diagnosis, but also in the second decade
after diagnosis. And when you think on that time scale, then the ten years
of tamoxifen versus five years of tamoxifen becomes rather more interesting.
It's an unanswered question, and I think it’s actually a very interesting
question. I’m quite optimistic that longer hormonal therapy can provide
even greater benefit. Ten years might provide even greater benefit than
five years, it might do. But that really is a research question, which
isn’t answered yet. What we do know is that at least five years of
hormonal treatment is very important to protect the women with ER+ disease
and that we no longer have any indication from the randomized trials of
any adverse effect of continuing beyond that.
