Hormone therapy is used for cancers that are hormone dependant. This is determined by the pathology department that examines the cancer after removal by surgery or biopsy. Medications are used to block the action of the hormone on the cancer and on the remaining breast tissue. New cancers can arise in the other breast or in the remaining tissue of the lumpectomy breast. These drugs help prevent new cancers as well as treating present cancer.
Tamoxiphen and Arimidex and Femara are used for breast cancers that are oestrogen (estrogen) sensitive.
Tamoxiphen started a revolution in breast cancer treatment. Its introduction led to a great decrease in recurrence rates and an increase in life expectancy. Women usually take Tamoxiphen daily for 5 years. Tamoxiphen directly blocks the action of estrogen at the estrogen receptor. Women before the menopause have high levels of estrogen and benefit most from Tamoxifen. Women who elect to have chemotherapy start Tamoxifen after finishing chemo. Some women who are started on Tamoxifen are switched to examestane (Aromasin) after 2 to 3 years.
Arimidex and Femara act differently from Tamoxifen. They are aromatase inhibitors. They interfere with how estrogen works. They are the choice for women who have passed the menopause and where the tumor has tested positive for estrogen sensitivity. The adrenal glands and fat cells still produce some estrogen after the ovaries stop functioning at the menopause, so the cancer in estrogen-sensitive women can still grow.