Women diagnosed with Estrogen-receptor positive breast cancer benefit from taking additional pill called Tamoxifen. The usual duration is usually 5 years therapy. The Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) trial randomized 12,894 women for 5 versus 10 years of Tamoxifen therapy. The study
found that women who took tamoxifen for ten years had a significantly
lower risk of breast cancer recurrence and lower death rate compared to women who took
tamoxifen for five years. However, taking Tamoxifen for 10 years also resulted in a significantly
higher incidence of adverse events including endometrial (uterine) cancer, blood clot in the lung, and ischemic heart disease.
Overall, this study recommends the use of tamoxifen for ten years, instead of five years. Patients with a relatively higher risk of recurrence based on their tumor characteristics (ie, pathological node involvement, large tumor size, or high tumor grade) seem to benefit even more. The study concluded: "For women with ER-positive disease, continuing tamoxifen to 10 years rather than stopping at 5 years produces a further reduction in recurrence and mortality, particularly after year 10. These results, taken together with results from previous trials of 5 years of tamoxifen treatment versus none, suggest that 10 years of tamoxifen treatment can approximately halve breast cancer mortality during the second decade after diagnosis"
Reference:
- Dizon DS, et al. Uptodate. Accessed 5-26-13
- Davies C, et al. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet. 2012
Overall, this study recommends the use of tamoxifen for ten years, instead of five years. Patients with a relatively higher risk of recurrence based on their tumor characteristics (ie, pathological node involvement, large tumor size, or high tumor grade) seem to benefit even more. The study concluded: "For women with ER-positive disease, continuing tamoxifen to 10 years rather than stopping at 5 years produces a further reduction in recurrence and mortality, particularly after year 10. These results, taken together with results from previous trials of 5 years of tamoxifen treatment versus none, suggest that 10 years of tamoxifen treatment can approximately halve breast cancer mortality during the second decade after diagnosis"
Reference:
- Dizon DS, et al. Uptodate. Accessed 5-26-13
- Davies C, et al. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet. 2012
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