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Risk of Late Recurrence Lower for Hormone Negative

Here’s a good news/better new flash: women with early stage breast cancer remain at low risk of recurrence years after treatment. That’s good. Better is that women with hormone negative cancers face a much smaller risk of later recurrence than those with hormone positive. This, despite the fact that hormone negative is considered to be more lethal than positive.

The study, by researchers at the University of Texas M.D. Anderson Cancer Center, included 2,838 women with stage I, II, or III breast cancer between 1985 and 2001. Five years after beginning therapy—chemotherapy, radiation, tamoxifen or all three—those with hormone negative disease faced a seven percent chance of recurrence, while those with hormone positive had a 13 percent chance.

The really good news: 89 percent of all patients had no recurrences within 10 years; 80 percent had no recurrences after 15 years. Within five years, those with stage I cancer had a 7 percent risk of recurrence; stage II faced an 11 percent risk; and stage III faced a 13 percent risk.

The research was published online in the Journal of the National Cancer Institute on August 11, 2008. Because HER2 was not routinely measured at the time and Herceptin and aromotase inhibitors had not been introduced, they were not included in the data. Until 2000, tamoxifen was the only drug for follow-up breast cancer care, and it was limited to women with hormone positive disease.

Researchers say that, while the numbers are small, the fact that cancer can recur years after therapy points to a need for more follow-up care. An interesting conundrum, considering the fact that women with hormone negative cancer faced a lower rate of late recurrence than women with hormone positive disease. That is, women for whom there never has been a long-term drug treatment option did better than women with the drug.

The study does point to continued need for regular follow-up exams and mammograms. I would also emphasize the importance of focusing on a low-fat, healthy diet with plenty of exercise, which have been proven to lower the risk of recurrence of hormone negative breast cancer.

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