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Becky,
I agree with you that endocrine therapy prevents additional hormone positive bc, but, IMO, longer duration therapy (past 5 years) with currently available treatments which affect all estrogen in the body, should be reserved for those patients at high risk. Prolonged estrogen deprivation comes with huge QOL effects. There has to be a balance. An unanswered question is what are we trading off to pursue this treatment? Osteoporosis and vascular disease down the road? A chance at ever again experiencing normal physical intimacy? We need to see overall survival stats, not just disease free survival stats, to answer that question before we consent to 10 years of treatment. Targeted ER therapy that would spare the rest of the body that needs ER to function normally would be a huge boon, would allow for longer treatment durations, and, I am certain, would greatly increase patient compliance with the drugs, which is key to success with them.
Hopeful
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