A new breakthrough in breast cancer care sounds like a cause for celebration. But is it too early for the champagne corks to be popping?

A DRUG with an unpronounceable name is being hailed as the biggest breakthrough in the fight against breast cancer for more than 20 years.

But while the national newspapers whip themselves up into a frenzy about its potential life-saving capabilities, a York doctor is warning women not to get too excited too soon.

Early results of research co-ordinated by Cancer Research UK show that women who took a five-year sequence of drugs - tamoxifen, the "gold standard" treatment for the disease, followed by exemestane - cut the risk of their cancer coming back by a third.

All the 4,700 post-menopausal women, 600 of whom were from Britain, who took part in the research started on tamoxifen but, after two or three years, half of them switched to exemestane.

Results published in the New England Journal of Medicine show that the risk of breast cancer returning was cut by a third in those who switched. For every 100 patients who changed to the new drug, eight had a recurrence within three years and 92 stayed cancer-free. For every 100 patients who continued on tamoxifen, 13 had a recurrence within three years.

The results also showed that taking a combination of the drugs cut the chance of a new cancer developing in the other breast by 50 per cent, and led to a drop in serious side-effects, including clotting.

All good news, you might think. But so-called medical breakthroughs such as this can often lead to confusion amongst patients. Should women on tamoxifen continue to take the tablets? Should they request a switch to exemestane?

Unfortunately, there can be far more questions than answers.

"It is far too early to get excited about this," said York GP Dr Sarah Bottom. "Doctors have not been issued with any information at this stage, but from what I can gather these are very early results. To be honest, we know as much as anyone reading the newspapers."

She said patients should continue to take their tamoxifen and, if they have any concerns, they should discuss them with their breast care nurse.

"Patients can rest assured that we have a cracking breast care clinic in York and that the treatment they are receiving is up to the minute in regard of current licences," she added.

Exemestane is licensed in the UK for patients with advanced breast cancer, not those in the early stages. And, so far, no further guidance has been issued by the Government.

More than 40,000 women develop breast cancer every year in the UK, and 13,000 die. Of the 30,000 post-menopausal women who develop breast cancer, about 20,000 are prescribed tamoxifen for five years after surgery because of its record in preventing the disease from recurring.

The new drug combination is most effective in the two-thirds of post-menopausal patients whose tumours are stimulated by the female hormone oestrogen. While tamoxifen works by blocking oestrogen's effects on cancer cells, exemestane shuts down the body's supply altogether.

"We know that tamoxifen is not 100 per cent curative, but it has brought about fantastic improvements," said Dr Bottom. "This research is very new and very specific. It's unkind when newspapers scare the pants off people with medical stories, but it's also unkind to hype something up at such an early stage.

"I suspect this is not actually a breakthrough at all, but one result from continuing research. Calling something a breakthrough makes a good headline though."

More research is to be carried out into possible long-term side-effects of the drug combination, such as bone thinning, and cost implications to the NHS (a course of exemestane would cost around £1,000 a year, about ten times higher than tamoxifen).

When the new treatment will be available is anybody's guess. Dr Bottom, perhaps not surprisingly, is not willing to be drawn on the subject: "All I will say is that this sounds good. Until more details emerge, that is the only sensible thing to say."

Updated: 10:57 Friday, March 12, 2004