The issues around mets are incredibly complex and hard to get your head around. Research such as reported in the abstract above does not give a clear picture. While bone is the most common site mets occur often in liver, lung, brain and less often elsewhere. Letrozole, tamoxifen etc are only protective where the cancer is highly positive for oestrogen receptors. Even so there are some cells which are like stem cells and evolve resistance to AI meds, hence the cancer finds new sources and starts growing again in the distant sites. I think we need a short but accurate publication setting out exactly what we do and don't know about mets. Another factor with studies like the above is that they include many cases from past years when tamox and AIs were not so widely used so the statistical analysis is compromised.
The 70% figure people have been quoting seems to have come out of nowhere. Can anybody cite the studies it has come from? It is still not clear to me what it refers to. Is it all those on anti oestrogens for five years? Does it include those with lower than 100% oestrogen positive type? How about those who went off meds before the 5 years was up? (As so many do due to intolerable side effects). It is incredibly important, as @arpie has so rightly said, that people understand as much as possible about their condition. For myself not one of my doctors at any stage has ever said a single word about the likelihood of mets even though I had a huge amount of invasive tumour and 9 lymph nodes involved. My daughter, a trained researcher, and I had to find everything out from the scientific and clinical literature by ourselves. There seems to be a general view that the less we know the better. Now I believe I am waiting for my mets but that's just how it is and life needs to be lived to the fullest possible extent in spite of that. But it does change your perspective.
