How Long Should Letrozole Be Taken for Hormonal Breast Cancer Treatment?

The duration of tamoxifen treatment for hormone receptor-positive breast cancer can vary depending on individual circumstances, but it is generally recommended to take it for 5 to 10 years. Always consult with your oncologist for personalized advice?

Hello Doctor, my mother has stage I breast cancer and has been taking "Tamoxifen" for a year and a half.
However, during her routine follow-up today, the doctor did not renew the prescription for Tamoxifen.
Before starting treatment, the doctor mentioned that she should take it for at least five years.
Now, after only a year and a half, the medication has suddenly been stopped.
I would like to know if this is correct.
I am very concerned that without continuing the medication, there is a risk of recurrence within five years.
Generally, how long should Tamoxifen be taken to reduce the risk of recurrence? Thank you for your response, and I wish you all the best.

Lin Xiao Yi, 40~49 year old female. Ask Date: 2024/04/09

Dr. Yuan Tianmin reply Breast and Thyroid

The standard treatment for oral anti-hormonal therapy is five years.
However, if you are wondering why it is no longer necessary to continue after a year and a half of treatment, it would be best to consult your mother's attending physician for a more detailed understanding of the situation.

Reply Date: 2024/04/09

More Info

Letrozole, marketed under the brand name Femara, is an aromatase inhibitor commonly used in the treatment of hormone receptor-positive breast cancer, particularly in postmenopausal women. The standard recommendation for the duration of letrozole therapy is typically five years. This duration is based on clinical trials that have demonstrated that extended use of aromatase inhibitors can significantly reduce the risk of cancer recurrence compared to shorter treatment periods.

In your mother's case, having been on letrozole for a year and a half, it is understandable to be concerned about the sudden discontinuation of the medication. The decision to stop or continue letrozole should ideally be based on a thorough evaluation by her oncologist, considering factors such as the cancer's characteristics, her overall health, and any side effects she may be experiencing. If the oncologist has not prescribed a continuation of letrozole, it may be due to various reasons, including the assessment that the benefits of continuing the medication do not outweigh the risks or side effects, or perhaps a change in treatment strategy.

It is crucial to understand that the goal of letrozole therapy is to lower estrogen levels in the body, which can help prevent the growth of hormone-sensitive tumors. Studies have shown that taking letrozole for five years can reduce the risk of recurrence by approximately 30-50% compared to not using it at all. Therefore, if your mother has a hormone receptor-positive breast cancer, continuing letrozole for the recommended duration is generally advisable to maximize the chances of preventing recurrence.

If there are concerns about the discontinuation of letrozole, it is essential to have an open discussion with her oncologist. Questions to consider asking include:
1. Why was letrozole not continued after a year and a half?
2. Are there alternative treatments or monitoring strategies in place?
3. What are the risks of stopping letrozole at this stage?
4. How will her cancer be monitored moving forward?
In addition to medication, lifestyle factors such as diet, exercise, and regular follow-ups play a significant role in managing breast cancer and reducing recurrence risk. Encouraging your mother to maintain a healthy lifestyle can complement her treatment and improve her overall well-being.

In summary, while the standard recommendation is to take letrozole for five years, individual treatment plans may vary. It is crucial to consult with her healthcare provider to clarify the reasons for any changes in her treatment regimen and to ensure that she is receiving the best possible care tailored to her specific situation.

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