Recurrence

A woman’s breast cancer recurrence risk can be significantly reduced with continued intake of the Novartis drug Femara (generically named letrozole), even long after she has stopped taking the estrogen blocker tamoxifen, according to a study published in the Journal of Clinical Oncology. Femara or letrozole belongs to a new family of drugs called aromatase inhibitors, which block the production of estrogen that can lead to some types of cancer.

Both tamoxifen and chemotherapy reduce the long-term risk of developing a second cancer in the unaffected breast, according to a report published in the January 2, 2008 issue of the Journal of the National Cancer Institute. The risk reduction lasts for at least 10 years with chemotherapy and 5 years with tamoxifen. The study analyzed 1,158 women who had cancer in one breast and an additional 634 who initially had cancer in one breast followed by development of cancer in the second breast.

These cancers have extra amounts of HER2 DNA, RNA, and protein. They usually have a high-grade appearance under the microscope. These cancers tend to grow rapidly and have a poor prognosis, although they often can be treated successfully with trastuzumab (Herceptin).

The luminal types are estrogen receptor-positive, usually low grade, and tend to grow slowly. The gene expression patterns of these cancers are similar to normal cells that line the breast ducts and glands (the lining of a duct or glad is called its lumen). Luminal A cancers have the best prognosis. Luminal B cancers generally grow somewhat faster than the luminal A cancers and their prognosis is not quite as good.

Three genomic tests separately predict the likelihood that a patient's breast cancer will recur after surgery without additional treatment, and the cancer's vulnerability to chemotherapy or hormone therapy, researchers at The University of Texas M. D. Anderson Cancer Center report at the first American Society of Clinical Oncology ASCO Breast Cancer Symposium Sept. 7-8 in San Francisco.