New treatment promises respite for young breast cancer patients

A new treatment is on the block that global studies report is more effective for young women affected by breast cancer than the older drugs.

Up to 4,960 pre-menopausal women patients were divided into two groups in a five-year clinical trial across 27 countries, including India. One group was put on aromatase inhibitor – exemestane, and the other on tamoxifen, both tablet-based drugs.

The study was conducted by International Breast Cancer Study Group, a Swiss non-profit cooperative research organisation.

Seventy-eight women patients from Tata Memorial Hospital (TMH) in Mumbai were a part of the trial. Doctors reported that at the end of five years, 92.8% women who were given exemestane were cancer-free as compared to the 88.8% who remained cancer-free after being put on tamoxifen treatment.

TMH doctors are considering using aromatase inhibitor therapy on a case-by-case basis as a substitute for chemotherapy in women who have been affected by hormone-sensitive breast cancer. They say this treatment will help women protect their fertility and they will be able to conceive after treatment.

Up to 23 Indian women in every 1 lakh get affected by breast cancer, with a large number getting the hormone-sensitive cancer.

"Breast cancers are of two types, hormone-sensitive and hormone-insensitive. Up to 55% of women who are premenopausal and aged below 50 are affected by hormone-sensitive cancer. With hormone therapy, there is a chance of protecting their fertility," said Dr Vani Parmar, professor, department of breast onco surgery.

"Earlier, this treatment option was offered only to post-menopausal women. With promising results of exemestane in pre-menopausal women received for the first time, this option may now be offered to very young women with highly hormone-sensitive tumours."

While the tamoxifen treatment is known to have high-risk side effects, such as thromboembolism or formation of clots in arteries and endometrial or uterine cancer, exemestane shows no such side effects.

"However, exemestane is known to cause a decrease in bone density. The women in the trial received regular bone density scans to keep a tab on their bone health," said Parmar.

Every year, TMH sees close to 4,000 new breast cancer patients from across India, the youngest patient being 19 years old.

Parmar, however, adds a word of caution. "The five-year study results are promising, but the type of tumours being treated mostly have higher recurrence rate even after five years. Hence, longer follow-ups will have to be observed," she said.