For patients with estrogen receptor-positive or progesterone receptor-positive breast cancer, treatment typically includes hormone therapy for at least five years after the initial treatment. Hormone therapy works by lowering estrogen levels and blocking cancer cells’ access to estrogen and progesterone, which they use to grow. It is recommended that patients with stage II cancer continue hormone therapy for more than five years. A new study investigated how often that actually happens.

Research recently published in the Journal of the National Cancer Institute included survey responses from 591 women who had just completed or were completing five years of hormone therapy. They’d all been diagnosed with stage I or II breast cancer between 2014 and 2015. Of the respondents, 557 had already decided their future plans. Among them, 39.4% of stage I survivors planned to remain on hormone therapy, along with a majority of stage II survivors – 62.4%. These findings were relatively good news to the researchers.

Dr. Lauren Wallner, co-senior author and associate professor of general medicine and epidemiology at the University of Michigan, says, "Endocrine therapy is less intensive than surgery, chemotherapy or radiation treatment. But the fact that it lasts five years—or now 10 years—can be challenging. It was encouraging to see that more than half of the higher-risk stage II patients chose to continue the therapy beyond five years.”

The survey responses showed that some of the main reasons behind the decision were worries about recurrence and the desire to utilize the most extensive treatment. The team also found that survivors were more likely to continue the treatment if their oncologist had recommended it or if their primary care physician was involved, showing that collaboration between all of a patient’s care providers may be helpful.

Dr. Sarah Hawley, co-senior author and professor of cancer control and population science at University of Michigan’s Rogel Cancer Center, says, "This study emphasizes the importance of a shared decision-making approach among cancer patients, oncologists and primary care physicians that may need to be revisited over time. This type of shared decision-making is becoming more common—and more necessary—as patients have more treatment options and decisions to make.”

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