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The 'Add-on' Treatments That Can Halve Breast Cancer Death Rates

Posted on: Friday, 13 May 2005, 18:00 CDT

TREATMENTS designed to prevent the recurrence of breast cancer have dramatically reduced death rates, say scientists.

In cases of the most common form of the disease, combinations of chemotherapy and the hormone therapy tamoxifen have halved the likelihood of middle-aged women dying.

The findings emerge from the biggest follow-up investigation of women diagnosed with early breast cancer undertaken.

Breast cancer is unusual in that it can recur after more than a decade of absence.

Even after surgery has removed all detectable traces, small numbers of cancerous cells may remain either in the breast or at other sites in the body.

These hidden deposits can grow back into life-threatening tumours.

Various 'add-on' treatments tested in the 1980s have been introduced to keep such a recurrence at bay. These include chemotherapy and tamoxifen.

Scientists from the Early Breast Cancer Trialists' Collaborative Group pooled data from 145,000 women who had taken part in 194 trials around the world.

The study underlines the success of the add-on treatments, and credits them for the rapid fall in death rates since the early 1990s.

Between 1990 and 2000 breast cancer incidence in the UK remained largely unchanged while death rates plummeted by 30 per cent.

Similar declines have been seen in the U.S. and other European countries.

The treatments studied incorporate six months of chemotherapy, involving combinations of drugs including anthracycline, followed by five years of tamoxifen.

Tamoxifen blocks the cancer-triggering effect of oestrogen in hormone-sensitive breast cancers, the most common type.

Under this regimen, a 50-year-old woman's one in five risk of dying from hormone-sensitive breast cancer is halved to about one in ten over 15 years.

The findings appear in The Lancet medical journal.

Professor Sarah Darby, from the University of Oxford, who took part in the study, said: ' For middle- aged women with hormone- sensitive breast cancer, six months of anthracycline - based chemotherapy and five years of tamoxifen halves the longterm risk of death from the disease.

'This is the largest analysis of randomised evidence ever done in any type of cancer.' Because the trials analysed began before 1995, none involve the latest generation of drugs such as taxanes or new aromatase inhibitors.

They are supposed to be more effective than tamoxifen.

Source: Daily Mail; London (UK)

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