Carla Bruni, Former French First Lady, Completes Five Years of Breast Cancer Hormone Therapy

Former French First Lady Carla Bruni announced on December 20, 2025, that she has completed five years of hormone therapy for breast cancer diagnosed in late 2019 marking a major survivorship milestone that showcases the power of early detection and treatment adherence.​

In an emotional Instagram post, the 57-year-old model and singer shared:

“Today I am completing five years of hormone therapy… Despite its rather aggressive side effects, I am grateful to science… Every year, on the same date, I do a mammogram.”

Photo: Depositphotos

Bruni’s journey from routine mammogram detection to no evidence of disease (NED) six years later embodies oncology’s gold standard: early screening + comprehensive treatment = survivorship success. Her story arrives as a timely reminder during the holiday season: annual mammograms save lives and preserve breasts.

The Diagnosis: Early Detection Success (Late 2019)

In late 2019, Carla Bruni’s routine annual mammogram performed as part of standard screening guidelines—detected a small, localized breast cancer at an early, highly curable Stage I level. This represents the gold standard of oncology prevention, where asymptomatic detection via imaging dramatically improves prognosis.

Breast-conserving surgery in the form of a lumpectomy was successfully performed, allowing for precise removal of the malignant lesion while preserving the natural structure of the breast. The tumor was small, measuring under 2 cm, and was excised with clear surgical margins, eliminating the need for more invasive procedures such as mastectomy. This approach achieved optimal oncologic control while maintaining cosmetic and functional integrity of the breast.

Following surgery, adjuvant radiotherapy was completed without complications. Targeted postoperative radiation, delivered over approximately three to six weeks, was used to eradicate any microscopic residual disease within the breast tissue. This strategy is associated with excellent local control rates exceeding 95% and plays a critical role in preventing local recurrence while safely avoiding full breast removal.

Pathologic analysis confirmed hormone receptor–positive disease, with estrogen and progesterone receptor expression identified. This finding positioned her as an ideal candidate for adjuvant endocrine therapy, a cornerstone of long-term recurrence prevention in early-stage breast cancer. Standard treatment typically involves five to ten years of Tamoxifen or an aromatase inhibitor, depending on menopausal status, and is known to reduce the risk of disease recurrence by approximately 50% by blocking estrogen-driven tumor growth.

Photo: Depositphoto Depositphotos Carla Bruni-Sarkozy and Nicolas Sarkozy attend the Appeal of Conscience Foundation’s 2008 World Statesman Award Ceremony at the Waldorf-Astoria Hotel in New York, NY, on September 23, 2008. Photo by Jason Smith / Everett Collection — Photo credit: everett225

The overall outcome highlights the profound impact of early detection. Timely diagnosis enabled complete breast preservation, minimized treatment-related morbidity, and supported both physical recovery and psychosocial well-being. By avoiding mastectomy and maintaining body image, she was able to achieve no evidence of disease (NED) status following completion of therapy—representing an optimal clinical result that aligns oncologic efficacy with quality of life.

Who Is Carla Bruni: From Music and Fashion to Cancer Advocacy

Carla Bruni (born December 23, 1967, in Turin, Italy) is an Italian-born French singer-songwriter, former international supermodel, and public figure. She moved to France as a child and later became one of the most recognizable faces in global fashion during the 1990s, working with leading designers such as Gianni Versace, Karl Lagerfeld, Yves Saint Laurent, Christian Dior, and John Galliano, and appearing on the covers of Vogue, Elle, and Harper’s Bazaar. At her peak, she ranked among the highest-paid models in the world.

MILAN, ITALY – SEPTEMBER 22: Carla Bruni, Claudia Schiffer, Naomi Campbell, Cindy Crawford, Helena Christensen, and Donatella Versace walk the runway at the Versace show during Milan Fashion Week Spring/Summer 2018 on September 22, 2017, in Milan, Italy — Photo by fashionst  

In the early 2000s, Bruni transitioned from fashion to music. Her debut album, Quelqu’un m’a dit (2002), achieved major commercial success in France and across Europe, selling over 2 million copies worldwide. She went on to release several critically recognized albums, including No Promises (2007), Comme si de rien n’était (2008), Little French Songs (2013), and French Touch (2017), establishing herself as a respected singer-songwriter known for her intimate, acoustic style.

Bruni became First Lady of France (2008–2012) after marrying Nicolas Sarkozy, then President of France. During this period, she used her public platform to support cultural, educational, and humanitarian causes. She later founded and became actively involved in initiatives focused on child protection, access to education, and global health, including work linked to the Fondation de France.

In 2019, Bruni was diagnosed with breast cancer. She publicly disclosed her diagnosis in 2021, emphasizing the importance of early detection and adherence to long-term treatment. On December 20, 2025, she announced that she had completed five years of adjuvant hormone therapy, marking a significant survivorship milestone. Her transparency has been widely recognized for helping normalize conversations around cancer treatment duration, side effects, and survivorship, particularly for hormone receptor–positive breast cancer.

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Hormone Receptor Positive Breast Cancer: Key Numbers and Facts

Hormone receptor–positive breast cancer, defined by the expression of estrogen receptors (ER) and/or progesterone receptors (PR), is the most common biological subtype of breast cancer worldwide.

Globally, approximately 70–75% of all breast cancers are hormone receptor–positive, according to large epidemiologic datasets cited by ASCO, NCCN, and the WHO. In postmenopausal women, this proportion is even higher, approaching 80%. HR+ tumors are typically slower growing than triple-negative disease but carry a long-term risk of late recurrence, often extending beyond 5–10 years after diagnosis.

In early-stage disease, patients with HR+ breast cancer have excellent initial prognosis, with 5-year survival rates exceeding 90–95% when treated according to modern standards. However, because estrogen-driven tumor cells can remain dormant for years, recurrence risk persists longer than with other subtypes, making endocrine therapy a cornerstone of management.

Endocrine (Hormonal) Therapy: How Often It Is Used

Endocrine therapy is recommended for nearly all patients with invasive HR+ breast cancer, regardless of tumor size, nodal status, or whether chemotherapy is given. According to NCCN and ASCO guidelines, over 85–90% of patients with early-stage HR+ breast cancer receive adjuvant endocrine therapy as part of standard care.

The two main classes of hormonal therapy include:

Tamoxifen, used in both premenopausal and postmenopausal patients
Aromatase inhibitors (AIs)—letrozole, anastrozole, or exemestane—primarily used in postmenopausal women or premenopausal women with ovarian suppression
Standard treatment duration is 5 years, but extended therapy to 7–10 years is now common in patients with higher-risk features.

Impact of Hormonal Therapy on Recurrence and Survival

Large meta-analyses from the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), cited by ASCO and NCCN, demonstrate that endocrine therapy provides one of the largest survival benefits in all of oncology.

Across multiple trials:

• Tamoxifen for 5 years reduces breast cancer recurrence by ~40–50%
• Breast cancer–specific mortality is reduced by ~30%
• Aromatase inhibitors further reduce recurrence risk by an additional 20–30% compared with Tamoxifen in postmenopausal patients

Extended endocrine therapy beyond 5 years can reduce late recurrence (years 5–15) by an additional 25–40% in selected patients, particularly those with node-positive disease.

Long-Term Outcomes in HR+ Breast Cancer

Despite excellent early outcomes, HR+ breast cancer is characterized by a continuous risk of relapse over decades. EBCTCG data show that even patients with small, node-negative tumors have a 10–20% cumulative risk of distant recurrence over 20 years if endocrine therapy is stopped early or not given.

This explains why survivorship care, adherence to hormonal therapy, and long-term follow-up are emphasized in modern guidelines.

Importantly, patients who complete the full course of endocrine therapy have significantly better outcomes than those who discontinue early. However, real-world data indicate that up to 30–40% of patients stop therapy prematurely, most often due to side effects such as hot flashes, arthralgia, fatigue, or mood changes highlighting the need for better symptom management and patient education.

Written by Aharon Tsaturyan, MD, Editor at OncoDaily Intelligence Unit