The types of chemotherapy and hormonal therapy that have long been used to help prevent breast cancer recurrence have much greater effects on 15-year than on 5-year survival, according to a study published in this week's issue of THE LANCET. This extra effect is one of the main reasons why breast cancer death rates have been falling rapidly ever since the early 1990s in the UK, the US and some other countries, state the authors.

In early breast cancer, surgery (or surgery and radiotherapy) can appear to remove all traces of the disease, but undetected deposits of cancer cells may remain that could, over the next 5, 10 or 15 years, develop into a life-threatening recurrence. Chemotherapy and/or hormonal therapy are often given as additional treatments in early breast cancer to help prevent recurrence, and can improve 5-year survival.

The Early Breast Cancer Trialists' Collaborative Group coordinated the world's largest collaborative analysis of cancer trials, bringing together data from 145,000 women with early breast cancer in 194 randomised trials. The study includes information on various treatments that were being tested in the 1980s, and have since been widely used, such as 6 months of anthracycline-based chemotherapy (in which an anthracycline is combined with two older drugs, fluorouracil and cyclophosphamide) and 5 years of tamoxifen.

The investigators found that where both chemotherapy and hormonal therapy are appropriate they can approximately halve the 15-year risk of death from breast cancer. For example, if a 50-year-old women had a one in 5 risk of dying from her hormone-sensitive breast cancer, then this risk could be halved, to about one in 10. For middle-aged women with breast cancer, 6 months of anthracycline-based chemotherapy reduces the breast cancer death rate over the next 10 or 15 years by about one third. For women of any age with hormone-sensitive early breast cancer, the commonest form of the disease, 5 years of ta
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Contact: Joe Santangelo
j.santangelo@elsevier.com
1-212-633-3810
Lancet
12-May-2005

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