Breast cancer can reappear 15 years after successful treatment, study claims

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"Older women are a vulnerable population at risk of developing and dying from breast cancer; however, screening mammography remains underutilized in these women", wrote Bethany L. Niell, MD, of the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, and colleagues.

The risk was directly related to the size of the original cancer and the number of lymph nodes that it affected.

Scientists analysed the progress of 63,000 women for 20 years.

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This is a type fuelled by the hormone oestrogen which can stimulate cancer cells to grow and divide.

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Patients in the study all received endocrine therapy - such as tamoxifen which is the standard of care to cut the risk of cancer recurrence - for five years and were free of cancer when they stopped therapy.

The study, which "quantifies the 20-year risk more reliably than previous studies", shows that, even after five years of adjuvant endocrine therapy with tamoxifen or aromatase inhibitors, women with oestrogen-receptor-positive (ER+) early-stage breast cancer have a persistent risk of recurrence and death later on.

Women who originally had large tumours and cancer that had spread to four or more lymph nodes were at highest risk of the cancer returning the next 15 years, the study said.

"However, even among women with small, node-negative (T1N0), low-grade tumours, there was a risk of distant recurrence of approximately 10% during years 5-20".

The current treatment for women with ER+ breast cancer is for them to take anti-oestrogen therapy for five years, but in some cases they take it for longer. In the UAE, the average age of diagnosis is 10 years younger than elsewhere in the world.

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Aromatase inhibitors, which will only work in women who are postmenopausal, are even better at reducing the risk of recurrence. He hopes that these results will motivate women who are experiencing side-effects while on this treatment to persevere with it.

Some patients stop their post-cancer treatment due to side effects that can include menopausal symptoms, osteoporosis, joint pain or carpal tunnel syndrome.

The research confirms that taking these drugs for five years does not remove the risk of breast cancer returning.

He said: "It's vital that work continues to better predict which cancers might return".

"We also need to know what the difference for women might be in taking hormone therapies for 10 years instead of 5, the side-effects and how this affects patients' quality of life", he added.

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