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Hormonal Carcinogenesis V pp 201–211Cite as

Response and Resistance to the Endocrine Prevention of Breast Cancer

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Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 617))

Current endocrine approaches to breast cancer (BC) prevention are targeted mainly at the estrogen receptor alpha (ERα) (1). Endocrine prevention depends upon either reducing the concentration of estrogen reaching ERα+ breast epithelial cells [estrogen deprivation (ED)] by, for example, ovarian suppression in premenopausal women, or aromatase inhibition in postmenopausal women, or by blocking the interaction of estrogen with ERα by selective estrogen receptor modulators (SERMs) such as tamoxifen (Tarn) and raloxifene (Ral). Observational studies (2–11) and randomised controlled trials (12–25) indicate that treatment by ED and SERMS reduces the risk of subsequent BC by approximately 50% and that this effect is prolonged (16, 18, 20, 26). In the human breast, ERα is detectable in epithelial cells of lobules and ducts and not in the stroma (27). However, it is not clear whether normal, premalignant or malignant epithelial cells are the targets for endocrine prevention. In this chapter, we summarise the results of endocrine prevention trials to date and what is known about the response of the three types of potential target structures to estrogen stimulation and inhibition by ED and SERMS.

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Author information

Authors and Affiliations

  1. CRC Department Medical Oncology, University of Manchester Christie Hospital and Holt Radium Inst., Manchester, UK

    Anthony Howell

  2. Cancer Research UK Centre for Epidemiol., Mathematics, and Statistics, Wolfson Institute of Preventive Medicine, London, UK

    Jack Cuzick

  3. Breast Biology Group Division of Cancer Studies, University of Manchester Christie Hospital (NHS) Trust, Manchester, UK

    Robert Clarke

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  1. Anthony Howell
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  2. Nigel J. Bundred
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  3. Jack Cuzick
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  4. D. Craig Allred
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  5. Robert Clarke
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Editor information

Editors and Affiliations

  1. Medical Center Department of Pharmacology, University of Kansas, Kansas City, KS, USA

    Jonathan J. Li PhD  & Sara A. Li PhD  & 

  2. Division of Cancer Biology, National Cancer Institute, Rockville, MD, USA

    Suresh Mohla PhD

  3. Hormone and Cancer Unit, U540, Montpellier University and INSERM, Montpellier, France

    Henri Rochefort MD/PhD

  4. Department of Cell Biology, Montpellier University 1-INSERM, U540 Hospital Arnaud de Villeneuve, Montpellier, France

    Thierry Maudelonde MD/PhD

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Howell, A., Bundred, N.J., Cuzick, J., Allred, D.C., Clarke, R. (2008). Response and Resistance to the Endocrine Prevention of Breast Cancer. In: Li, J.J., Li, S.A., Mohla, S., Rochefort, H., Maudelonde, T. (eds) Hormonal Carcinogenesis V. Advances in Experimental Medicine and Biology, vol 617. Springer, New York, NY. https://doi.org/10.1007/978-0-387-69080-3_19

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