Common questions

Many women have these common questions about hormonal therapy, but you may have others as well. Keep a list of your questions to discuss with your providers.

How long will I take hormonal therapy?

Standard treatment with hormonal therapy medicines for early-stage breast cancer used to be 5 years, whether you took tamoxifen or an aromatase inhibitor (AI). But a major study recently found that extending tamoxifen from 5 to 10 years increases its benefit.

Today, tamoxifen may be given for 5 to 10 years. If you are premenopausal, your doctor may recommend either 5 or 10 years of tamoxifen. If you are postmenopausal, you may receive up to 10 years of hormonal therapy treatment. You might start, for example, with up to 5 years of tamoxifen, and then switch to an AI to complete a total of 10 years of hormonal therapy

AIs are the standard of care for postmenopausal women. If you are postmenopausal and take an AI without taking tamoxifen before, the standard of care remains 5 years of AI therapy.

Staying on your hormonal therapy for these amounts of time, and taking the recommended dose, is important. Research shows these time lengths are effective in reducing the risk of cancer returning. If you have difficult side effects or want to stop hormonal therapy for any reason, talk with your doctor or nurse. They may be able to help you manage the side effects or explore other options.

As research develops, the length of hormonal therapy treatment could change. Ask about clinical trials you could join before you begin hormonal therapy or after completing treatment. You also may be able to take treatment breaks.

In metastatic breast cancer, hormonal therapy is often given as the first treatment for hormone-sensitive disease. You may continue to take hormonal therapy as long as it keeps the cancer from growing. If the cancer grows, you may be switched to a new hormonal therapy or other treatments.

Which hormonal therapies should I use?

You and your doctors will consider many factors when choosing your hormonal therapy. In addition to the medical issues, you may want to consider:

• Timing. Hormonal therapy is a commitment. It means taking medicine every day for 5 to 10 years. Doing so keeps an even level of hormonal therapy in your body and makes treatment most effective.
• Risk reduction. Hormonal therapy reduces the risk the cancer will return in early-stage breast cancer. Yet you might be willing to accept a higher risk if you don’t have to take a specific medicine or have your ovaries removed. Ask your doctor how much you can reduce your risk with each suggested treatment.
• Side effects. Learn what these may be for the hormonal therapy you will take. Your family history, past medical history or other personal concerns might affect your choice.
• Cost. Many hormonal therapies are available in low-cost, generic form. Talk early with your healthcare team for advice about programs to help you pay for your medicine.