WEDNESDAY, Aug. 31 (HealthDay News) -- Some breast cancer
patients over the age of 60 who have small, early-stage tumors can
skip hormone therapy without increasing their risk of death, a new
The women in the study had tumors that were hormone-receptor
positive, which means they require estrogen to grow. Among other
things, hormone therapy for these tumors is designed to starve the
breast cancer cells by lowering the amount of estrogen in the
But this therapy also has side effects that can be debilitating
and occasionally even life-threatening, so the researchers wanted
to determine its benefit for women with a low risk of cancer
To do so, researchers from Denmark followed 3,197 women with
breast cancer, ages 35 to 74, who had no lymph node involvement.
They were not given the hormone therapy that is typically given to
women who have hormone receptor-positive tumors.
The researchers followed the women for a median of nearly 15
years. They found that those aged 60 and older with smaller tumors
did not have any greater risk of death than the general population
in the same age range. (Tumors of 10 millimeters or less were
In recent years, the trend has been to give all women with
hormone-receptor positive breast cancer hormone treatment after
surgical treatment, said study author Dr. Peer Christiansen,
professor at the Aarhus University Hospital in Denmark. "But based
on this study, benefit is not expected in the low-risk group in
The research is published in the Aug. 31 issue of the
Journal of the National Cancer Institute.
During the follow-up period, 970 women died. The risk of dying
was higher than that of the general population in those with larger
tumors, 11 millimeters to 20 millimeters in size. There was also an
excess risk of dying in younger women, aged 35 to 59, compared to
the general population. However, women 60 and older did not have a
The researchers focused primarily on whether the lack of hormone
therapy increased the risk of death. But they also looked at cancer
recurrences. "The identified low-risk group had fewer local and
distant recurrences than patients not belonging to this group,"
"In Denmark, 85 percent of all patients with breast cancer have hormone-receptor positive tumors," Christiansen said. According to the American Cancer Society, two out of three breast cancers are these so-called ER-positive tumors.
The findings echo some previous studies, said Jennifer Griggs,
an associate professor of internal medicine at the University of
Michigan, in Ann Arbor. She co-authored an editorial on the study.
The risk of death is already low in these patients with very small,
hormone-positive beast cancer without lymph node involvement, she
The new study ''confirms what we know, but it leaves open a lot
of questions as well," she said. "Not everyone needs systemic
[hormone] therapy, but the question we are stuck with is, 'Who
Despite the findings, she writes that many women will want to
take the hormone therapy to reduce their risk of recurrence, both
in the breast with the original cancer and the opposite breast.
The greatest benefit of the therapy, she said, may be to prevent
these recurrences. However, she said, some women have trouble
tolerating the side effects of the hormone therapy. Those can
include hot flashes and joint pain.
For those women who aren't sure if they want to go on the
hormone therapy, which is typically given for five years, Griggs
suggested they consider a trial of about three months. Then,
depending on side effects, the woman can decide whether to stay on
the treatment or not.
To learn more about hormone therapy for breast cancer, visit the
American Cancer Society.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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