Specialists took issue with a separate analysis of that study, which hinted at a bigger benefit from starting on Femara. And pooled results of prior studies involving 20,000 women suggest that any such advantage is very small.
"At this point in time, there is a slight increase in survival in patients treated with AIs but it is not statistically significant," said that study's leader, Dr. James Ingle of the Mayo Clinic in Rochester, Minn.
"The only really fair interpretation is that all of these are the same," and that women should include one at some point in their treatment as guidelines now recommend, Winer said.
About 90,000 women in the United States and many more worldwide each year face this decision, and key issues are cost and side effects.
Both drugs can cause hot flashes. Tamoxifen raises the risk of endometrial cancer and blood clots. The aromatase inhibitors can cause more bone loss, vaginal dryness, problems having sex, joint pain and muscle aches.
"Many of us think that overall, they're drugs that are a little harder to take," Winer said of the newer drugs.
"When you put it all together it's almost a balancing act," depending on each woman's health history and risks, said Dr. C. Kent Osborne, a breast cancer specialist at Baylor College of Medicine ghelaniin Houston. The San Antonio Breast Cancer symposium is sponsored by the American Association for Cancer Research, Baylor and the University of Texas Health Science Center at San Antonio.
ref: thetimesofindia
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