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Tamoxifen Trial Should Prompt Breast Cancer Patients to Reconsider Treatment Options

MAYWOOD, Il. -  A groundbreaking clinical trial involving the breast cancer drug tamoxifen should prompt certain breast cancer patients to reconsider their treatment options, according to Loyola University Medical Center breast cancer specialist Dr. Kathy Albain.

The trial is called ATLAS (Adjuvant Tamoxifen Longer Against Shorter). It included women with estrogen receptor-positive breast cancer that had not spread to distant organs. Women who took tamoxifen for 10 years had a lower risk of recurrence and lower mortality rate than women who took the drug for five years, which is the current standard of care.

"I think this is going to create a need for women with this type of breast cancer to readdress their treatment options," Albain said.

Dr. Richard Gray, on behalf of the ATLAS trial investigators, announced the study results Dec. 5 during the San Antonio Breast Cancer Symposium. Albain moderated the opening oral session in which the results were announced and discussed.

A worldwide team of investigators enrolled 6,846 women with estrogen receptor-positive breast cancer who had been taking tamoxifen for five years and were free of recurrence of their breast cancer. Women were randomly assigned to either stop taking tamoxifen, or to continue taking the drug for another five years.

During the second decade following diagnosis, women who continued taking tamoxifen had a 25 percent lower recurrence rate and a 29 percent lower breast cancer mortality rate, compared with women who stopped after five years. Overall, taking tamoxifen for 10 years cut the risk of dying of breast cancer in half.

Albain noted there are risks to taking tamoxifen, including a higher risk of endometrial cancer in postmenopausal patients and an increased risk of blood clots. But endometrial cancer generally is curable, and in certain women, the benefits of taking tamoxifen for longer periods may outweigh the risks, Albain said.

Premenopausal women may benefit by taking tamoxifen for 10 years rather than five years, Albain said. The picture is more complicated for postmenopausal women. Depending on the patient, a regimen could involve taking tamoxifen for a period of time and an aromatase inhibitor for a period of time.

"Each woman's situation is different, which is why she should consult her doctor on the best course of action in light of these exciting and significant new findings," Albain said.

Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

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Jim Ritter
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