Hello from an old fogie. Hope you don’t mind me posting here but I read this Breast Cancer News service circular to-day which applies to you. I’ve also posted it on the “recently diagnosed” thread as I think it may save a lot of unnecessary treatment and suffering.
Are you under 40? If so, some recently published research shows that if your cancer is diagnosed as Oestrogen Receptor Positive (ER+) then maybe chemotherapy is not going to give you any benefit and you could avoid all the nastiness and side effects of this treatment. If your cancer is ER- Oestrogen Receptor Negative, then chemotherapy is beneficial.
I’m pasting the whole text of the two articles I read to-day on the news service I subscribe to: BCN, so that you can discuss this with your medical team, particularly your oncologist. These are not the first reports to discuss this topic.
I hope this may empower you to ask some questions and become an active partner in decision making about your treatment. Don’t take for granted that the standard treatment is best for you. Increasingly treatments are being tailored to individual’s profiles.
Information will help you to understand the steps ahead of you as they arise so don’t be afraid to ask questions. Fact: The most quizzy and difficult patients live longest!!
Wishing you well,
Jenny
Here’s the text:
Cancer conflict with chemotherapy treatment: Young women suffering from breast cancer do not necessarily benefit from chemotherapy treatment
[Eureka News Service]
Women under the age of forty with breast cancer who are given drugs in addition to lumpectomies or radiotherapy, known as adjuvant chemotherapy, may not be benefiting from these drugs. This is especially true if their tumors respond to changing levels of hormones such as estrogen, according to research published in the online journal, Breast Cancer Research.
“Developing breast cancer at a young age is very worrying in terms of survival,” explained lead researcher Dr J van der Hage. “But some young women may be undergoing not only unpleasant but also unnecessary chemotherapy, which can be avoided.”
Almost 10% of women diagnosed with breast cancer in Europe are under the age of forty. Two thirds of breast cancers, known as estrogen receptor positive (ER+), contain high levels of cells which contain estrogen receptors. These tumors tend to grow less aggressively than estrogen receptor negative (ER-) tumors. Young patients with breast cancer are currently advised to undergo courses of chemotherapy as well as removal of the tumor and/or entire breast. A research team of the European Organisation for Research and Treatment of Cancer (EORTC) selected patients from four EORTC-trials which were coordinated by Professor C.J.H. van de Velde from the Leiden University Medical Center, to study the effect of chemotherapy in young women. The research team found that ER+ patients, while they benefited from their chemotherapy treatment, did not survive at higher rates than ER- patients.
The difference in survival rates between the two treatment groups was just 5% (in favour of the ER- group), indicating that the chemotherapy gave no advantage. Of all the patients examined, including those who had only undergone primary treatment such as mastectomy, over 25% had died seven years after initial diagnosis.
“Adjuvant chemotherapy is a well established, but ineffective treatment in ER+ breast cancer patients aged 40 years or less . Hormone responsiveness is the key to tailoring therapy in the future fight against this disease for young women,” concluded Dr van der Hage.
OPEN ACCESS: Efficacy of adjuvant chemotherapy according to hormone receptor status in young patients with breast cancer: a pooled analysis
[Breast Cancer Research]
Introduction: Breast cancer at a young age is associated with an unfavorable prognosis. Very young patients with breast cancer therefore are advised to undergo adjuvant chemotherapy irrespective of tumor stage or grade. However, chemotherapy alone may not be adequate in young patients with hormone receptor-positive breast cancer. Therefore, we studied the effect of adjuvant chemotherapy in young patients with breast cancer in relation to hormone receptor status.
Methods: Paraffin-embedded tumor material was collected from 480 early-stage breast cancer patients younger than 41 years who participated in one of four European Organization for Research and Treatment of Cancer trials. Using immunohistochemistry on the whole series of tumors, we assessed estrogen receptor (ER) status and progesterone receptor (PgR) status in a standardized way. Endpoints in this study were overall survival (OS) and distant metastasis-free survival (DMFS). The median follow-up period was 7.3 years.
Results: Overall, patients with ER-positive tumors had better OS rates (hazard ratio [HR] 0.63; P = 0.02) compared with those with ER-negative tumors. However, in the subgroup of patients who received chemotherapy, no significant difference in OS (HR 0.87; P = 0.63) and DMFS (HR 1.36; P = 0.23) was found between patients with ER-positive tumors or those with ER-negative tumors. These differences were similar for PgR status.
Conclusion: Young patients with hormone receptor-positive tumors benefit less from adjuvant systemic chemotherapy than patients with hormone receptor-negative tumors. These results confirm that chemotherapy alone cannot be considered optimal adjuvant systemic treatment in breast cancer patients 40 years old or younger with hormone receptor-positive tumors.
[NOTE: For the full paper, please follow the supplied link.] 1 to 1 of
