If your doctor takes a sample from your breast lump, he or she is able to find via a number of tests whether or not your tumour is being encouraged to grow by your own natural oestrogen. If this is the case, your doctor will tell you that your breast lump is hormone receptor-positive or oestrogen receptor-positive and will almost certainly recommend treatment after surgery in the form of hormonal therapy.
Hormonal therapy is designed to stop the cancer cells receiving the supply of oestrogen which encourages them to grow, it is generally well-tolerated and without many of the distressing side effects associated with chemotherapy. It is not the same as hormone replacement therapy (HRT), which is given to healthy women to increase oestrogen in the body following the menopause (the “change”), to control menopausal symptoms such as hot flushes and to prevent the development of osteoporosis in the long term.
There are a number of types of hormonal drugs for breast cancer, the most widely used drug being tamoxifen, which blocks the action of oestrogen on the tumour, stopping its growth. Other, newer hormonal drugs have become available, which act in different ways from tamoxifen but have an effect upon oestrogen production within your body. One group of drugs, known as LH-RH analogues, work in premenopausal women who still have regular periods. They ‘switch off’ the ovaries, preventing them from producing oestrogen. These drugs have the same effect as surgically removing or irradiating the ovaries but their effect can be reversed when treatment is completed and the woman’s periods may start again. In older women, after the menopause, the ovaries are not active and oestrogen is produced in different parts of the body. This process is blocked by another group of drugs known as aromatase inhibitors.
Side effects of hormonal therapy The side effects usually associated with hormonal therapies are similar to those experienced by women going through the menopause, such as hot flushes, vaginal spotting, and nausea. However, a number of different hormonal drugs are now available and you should discuss the benefits and possible side effects of these with your doctor very carefully before deciding on which treatment you receive.
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