Another option for premenopausal women with breast cancer

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A drug that reduces the amount of estrogen in the body can help prevent a recurrence of breast cancer in premenopausal women with the disease. Two years of therapy with the drug, Zoladex, was shown to be just as effective as taking two years of the drug tamoxifen in women who were followed for 15 years after their initial treatment.

The study, published today in the Journal of the National Cancer Institute, offers reassurance to women who choose to take Zoladex rather than tamoxifen to prevent breast cancer recurrence or who discontinue tamoxifen because of side effects and want another alternative. The study, by researchers at University College London, followed 2,706 premenopausal women. After their initial treatment of surgery, radiation or chemotherapy, the women were assigned to one of four prevention programs: no hormonal therapy, two years of tamoxifen alone, two years of Zoladex alone or Zoladex plus tamoxifen. The study concluded that Zoladex was just as effective as tamoxifen in preventing a recurrence after 15 years. Zoladex, also known by the generic name goserelin, is a luteinizing hormone-releasing hormone agonist that reduces estrogen in the bloodstream.

There was a marginal benefit of taking both Zoladex and tamoxifen over tamoxifen alone -- a difference of 2% to 3%. However, that may be important given the number of younger women with breast cancer. Moreover, women who stop taking tamoxifen before the end of the recommended five-year treatment period may want to consider taking Zoladex, said the authors of the study. Zoladex is given by injection while tamoxifen is taken orally. Both drugs can cause hot flashes, and Zoladex is associated with bone loss. ‘It may be that women who are unlikely to complete five years of tamoxifen tablets may prefer two years of goserelin injections,’ the authors wrote.

The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute.

-- Shari Roan