We can see that after 20 years, the risk of distant metastases, that is, spread to other organs, was reduced among women who received hormone-lowering therapy with tamoxifen, goserelin, or a combination of the two, compared to women who received hormone-lowering therapy. He received no hormone-lowering treatment, says the study’s first author Anneli Johanssonpostdoc in Department of Oncology – PathologyKarolinska Institutet.
It is possible to predict future risks
In recent years, researchers have also analyzed patients’ tumors from the previous STO-5 study using modern technology. For example, they investigated several markers of breast cancer, such as estrogen receptors and progesterone receptors, as well as tumor gene expression using a genetic risk signature.
The signature measures the activity of 70 different genes, which boils down to the degree of risk. It makes it possible to predict the future development of cancer cells at an early stage and thus classify patients into low and high genomic risk, respectively.
Tumors of patients with a high genetic risk usually have a higher rate of cancer growth. Therefore these patients are at risk of relapse early and therefore require more aggressive treatment, for example with goserelin, which rapidly and effectively reduces estrogen levels. On the other hand, patients with less aggressive disease appear to be at risk of relapse in the long term. In these cases, tamoxifen appears to provide better protection, Anneli Johansson says.
Although the study is relatively small, it highlights the importance of individualized treatment for hormone-sensitive breast cancer. For some patients, more aggressive treatment may be necessary to survive, while for others a milder treatment may be sufficient, reducing side effects and providing a better quality of life. However, follow-up studies are needed before major changes in treatment recommendations can be implemented.
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