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Adding Aromasin to Ovarian Suppression Improves Cancer-Free Time for Breast Cancer Patients

Aromasin used to suppress hormones was more effective than tamoxifen in preventing breast cancer recurrence, but also had more side effects.

Aromatase inhibitors such as Aromasin are frequently prescribed after surgery or radiation in postmenopausal women with breast cancer. Now a study of 4,600 premenopausal women shows that this drug can reduce recurrence significantly for them as well.

All the women had hormone-receptor-positive early breast cancer. They were randomly assigned to receive either tamoxifen or exemastane (Aromasin) along with ovarian suppression for five years after their initial diagnosis.

After five years, 93 percent of those on exemestane were cancer free. That compared to 89 percent of those taking tamoxifen. There was no significant difference between the two groups with respect to survival. The Aromasin protocol was associated with osteoporosis in 13 percent of participants, compared to 6 percent of those on the tamoxifen protocol.

Aromasin is quite a bit more expensive than the generic tamoxifen, so it remains to be seen whether third party payers will consider the benefits great enough to cover the cost.

[NEJM, July 10, 2014]

In the People’s Pharmacy perspective, treatments that offer a survival advantage should definitely be covered by insurance. Unfortunately, this research leaves a bit of gray zone in the cost/benefit analysis, since there was no survival advantage and since the more effective (and more expensive) medication also triggered side effects in more women. No doubt insurers will fight about this for some time to come, but it is very helpful to have the evidence that this treatment which works for older women also works for those whose breast cancer occurred before menopause.


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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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