Fertility concerns influence treatment decisions in younger patients with breast cancer
the ONA take:
Previous studies have shown that following a 5-year course of tamoxifen after breast cancer treatment can reduce recurrence by 47% and mortality by 26%.
In addition, more recent data suggests taking tamoxifen for 10 years may be even more beneficial. However, many patients with breast cancer, especially premenopausal women, decline the therapy or discontinue it in less than 5 years.
This study found that 13% of patients declined tamoxifen therapy and 16% stopped before the recommended 5 years of treatment were up.
Phone interviews conducted with 88 patients who did not initiate or discontinued tamoxifen revealed concerns about fertility and side effects were primary factors for these patients’ decision.
The researchers conclude these findings demonstrate a need to include appropriate counseling for patients who express concerns about future fertility at the outset as part of a multidisciplinary treatment plan.
They suggested that a dialog about fertility could identify more patients willing to complete the recommended course if they could delay or take a break from the therapy to allow for pregnancy.
A new international trial, called POSITIVE, being conducted by the International Breast Cancer Study Group, is looking at whether premenopausal women who take a hiatus to become pregnant then resume the therapy would have similar benefit as those who taken tamoxifen continuously for 5 years.
Previous studies have shown that following a 5-year course of tamoxifen after breast cancer treatment can reduce recurrence.
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