Taking an aromatase inhibitor can cut your risk of being diagnosed with breast cancer by 65%, says a study released last week at the annual meeting of the American Society of Clinical Oncology (ASCO), and published simultaneously in the New England Journal of Medicine.
The news made headlines in Sunday papers from coast to coast this weekend, with many doctors and researchers hailing it as a new era in breast cancer prevention.
WOW. Sign me up, right?
Not so fast.
I don’t mean to be a spoilsport, but let’s look at the facts.
Many of us survivors have been taking aromatase inhibitors (Aromasin, Femara, and Arimidex) for years to prevent a recurrence of breast cancer. This new study is the first focusing on these AIs (specifically, Aromasin) as breast cancer preventive agents.
And what does it show, exactly?
That if you’re postmenopausal, and at moderate to high risk for breast cancer – which study authors define as carrying the BRCA genes; OR having a relative with breast cancer; OR being over 60 years old – taking Aromasin will reduce your risk by 65%.
OK, carrying a BRCA gene does put you at high risk. But having a relative with breast cancer increases your risk very minimally – a risk that was already extremely low, in most cases.
And being 60 years old?
If you’re 60 years old, your chance of developing breast cancer in the next 10 years is 3.6%.
Hardly what I’d call high risk.
Take an AI for 3 years, your risk is cut by 65% - which sounds impressive, but translates to a reduction of 2.3%, in absolute terms. Your risk is down to 1.3% – from its original 3.6%.
Nancy E. Davidson, MD, of the University of Pittsburgh Cancer Institute, and Thomas W. Kensler, PhD, of the UPMC Cancer Centers in Pittsburgh, in an NEJM editorial accompanying results of the study, pose the following question:
"We have run out of excuses. What are we waiting for?"
I consider this hopelessly disingenuous. I’ll tell you, Docs, as someone who took an AI for 5 years, I’d suggest women hesitate before starting on a course of treatment that may reduce their cancer risk by a mere 2.3% - and here's why:
Hot flashes and mood swings. Vaginal dryness, and painful sex. Bone and joint pain so severe that many breast cancer survivors, having suffered through months of it, decide they’d rather take their chances with cancer.
And then there’s bone loss: AIs weaken bones and put many women into osteopenia, which is one short step from osteoporosis.
And hair loss: some women find themselves losing their hair – not just a few strands, but actually going bald.
Statistically speaking, 94 women would have to take an AI for 3 years to prevent a diagnosis of breast cancer in 1 woman. That’s 94 women suffering everything from minor hot flashes to loss of their libido to crippling bone loss for the chance – just the chance – that they’ll be that one woman who’s actually helped by the drug.
Oh, and one more thing. The study hasn’t yet accumulated enough data to show whether AIs reduce your risk of dying from breast cancer. Thus far, all that’s known is that AIs can lower your risk of a breast cancer diagnosis – from really low, to really, really low.
As a breast cancer survivor determined to do all I can to prevent cancer’s return, I had a hard time finishing my 5-year course of Arimidex. In fact, I quit with the final prescription only half gone, due to back pain so severe I couldn’t sit, stand, ride a bike, or get out of bed normally.
So, to suggest that a perfectly healthy woman leap at the chance to endure pain, bone loss, baldness, and a compromised sex life in order to reduce her cancer risk by 2.3% –
Sorry, I’m just not getting it.
Published On: June 05, 2011