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Risk Reduction Strategies: Medical Oncology

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Management of the Patient at High Risk for Breast Cancer

Abstract

In the United States it is estimated that in 2012 more than 40,000 women will die of breast cancer and 229,060 women will be diagnosed with the disease [1]. Although early detection strategies, such as mammograms, have been successfully implemented, 10 % of women will be diagnosed with four or more lymph nodes involved [2]. It has long been thought that the steps leading to cancer development in the breast take place during a long period of time. Support of this notion comes from data in women exposed to radiation. Among patients who received chest radiation for Hodgkin’s disease, a cancer of the lymph nodes, as well as the survivors of the atomic bombing, it has been found that the greatest risk of developing breast cancer is when the radiation exposure took place during the early teen years [3]. However breast cancer in those individuals occurred at least 10–15 years later. Additional data come from infants undergoing radiation to the thymic gland, a gland located in the chest, [4] and girls in puberty who received radiation during a procedure for the diagnosis of tuberculosis [5].

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References

  1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10–29.

    Article  PubMed  Google Scholar 

  2. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225–49.

    Article  PubMed  Google Scholar 

  3. Tokunaga M, Land CE, Yamamoto T, et al. Incidence of female breast cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950–1980. Radiat Res. 1987;112:243–72.

    Article  PubMed  CAS  Google Scholar 

  4. Hildreth NG, Shore RE, Dvoretsky PM. The risk of breast cancer after irradiation of the thymus in infancy. N Engl J Med. 1989;321:1281–4.

    Article  PubMed  CAS  Google Scholar 

  5. Miller AB, Howe GR, Sherman GJ, et al. Mortality from breast cancer after irradiation during fluoroscopic examinations in patients being treated for tuberculosis. N Engl J Med. 1989;321:1285–9.

    Article  PubMed  CAS  Google Scholar 

  6. Jordan VC, Costa AF. Chemoprevention. In: Harris JR, editor. Diseases of the breast. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2000.

    Google Scholar 

  7. Jordan VC, Lababidi MK, Mirecki DM. Anti-oestrogenic and anti-tumour properties of prolonged tamoxifen therapy in C3H/OUJ mice. Eur J Cancer. 1990;26:718–21.

    Article  PubMed  CAS  Google Scholar 

  8. Jordan VC, Lababidi MK, Langan-Fahey S. Suppression of mouse mammary tumorigenesis by long-term tamoxifen therapy. J Natl Cancer Inst. 1991;83:492–6.

    Article  PubMed  CAS  Google Scholar 

  9. O’Regan RM, Jordan VC. Tamoxifen to raloxifene and beyond. Semin Oncol. 2001;28:260–73.

    Article  PubMed  Google Scholar 

  10. Anonymous. Tamoxifen for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group. Lancet. 1998;351:1451–67.

    Google Scholar 

  11. Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst. 1998;90:1371–88.

    Article  PubMed  CAS  Google Scholar 

  12. Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for the prevention of breast cancer: current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study. J Natl Cancer Inst. 2005;97:1652–62.

    Article  PubMed  CAS  Google Scholar 

  13. Cuzick J, Forbes JF, Sestak I, et al. Long-term results of tamoxifen prophylaxis for breast cancer—96-month follow-up of the randomized IBIS-I trial. J Natl Cancer Inst. 2007;99:272–82.

    Article  PubMed  CAS  Google Scholar 

  14. Powles T, Eeles R, Ashley S, et al. Interim analysis of the incidence of breast cancer in the Royal Marsden Hospital tamoxifen randomised chemoprevention trial. Lancet. 1998;352:98–101.

    PubMed  CAS  Google Scholar 

  15. Veronesi U, Maisonneuve P, Costa A, et al. Prevention of breast cancer with tamoxifen: preliminary findings from the Italian randomised trial among hysterectomised women. Italian tamoxifen prevention study. Lancet. 1998;352:93–7.

    PubMed  CAS  Google Scholar 

  16. Anzano MA, Peer CW, Smith JM, et al. Chemoprevention of mammary carcinogenesis in the rat: combined use of raloxifene and 9-cis-retinoic acid. J Natl Cancer Inst. 1996;88:123–5.

    Article  PubMed  CAS  Google Scholar 

  17. Gottardis MM, Jordan VC. Antitumor actions of keoxifene and tamoxifen in the N-nitrosomethylurea-induced rat mammary carcinoma model. Cancer Res. 1987;47:4020–4.

    PubMed  CAS  Google Scholar 

  18. Delmas PD, Bjarnason NH, Mitlak BH, et al. Effects of raloxifene on bone mineral density, serum cholesterol concentrations, and uterine endometrium in postmenopausal women. N Engl J Med. 1997;337:1641–7.

    Article  PubMed  CAS  Google Scholar 

  19. Cummings SR, Eckert S, Krueger KA, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the more randomized trial. Multiple outcomes of raloxifene evaluation. JAMA. 1999;281:2189–97.

    Article  PubMed  CAS  Google Scholar 

  20. Vogel VG, Costantino JP, Wickerham DL, et al. Update of the National Surgical Adjuvant Breast and Bowel Project Study of Tamoxifen and Raloxifene (STAR) P-2 Trial: Preventing Breast Cancer. Cancer Prev Res (Phila). 2010;3(6):696–706.

    Article  CAS  Google Scholar 

  21. Cummings SR, Ensrud K, Delmas PD, et al. Lasofoxifene in postmenopausal women with osteoporosis. N Engl J Med. 2010;362:686–96.

    Article  PubMed  CAS  Google Scholar 

  22. Powles T, Diem S, Wickerham DL, et al. Effects of arzoxifene on breast cancer incidence in postmenopausal women with osteoporosis or with low bone mass. Cancer Res. 2009;69:499s.

    Article  Google Scholar 

  23. Goss PE, Ingle JN, Ales-Martinez JE, et al. Exemestane for breast-cancer prevention in postmenopausal women. N Engl J Med. 2011;364:2381–91.

    Article  PubMed  CAS  Google Scholar 

  24. Anonymous. IBIS-II. International Breast Cancer Intervention Study. 2010

    Google Scholar 

  25. Chlebowski RT, Chen Z, Cauley JA, et al. Oral bisphosphonate and breast cancer: prospective results from the Women’s Health Initiative (WHI). Cancer Res. 2009;69:489s.

    Google Scholar 

  26. Li Y, Brown PH. Prevention of ER-negative breast cancer. Recent Results Cancer Res. 2009;181:121–34.

    Article  PubMed  CAS  Google Scholar 

  27. Boudreau DM, Yu O, Johnson J. Statin use and cancer risk: a comprehensive review. Expert Opin Drug Saf. 2010;9(4):603–21.

    Article  PubMed  CAS  Google Scholar 

  28. Lord CJ, Ashworth A. Targeted therapy for cancer using PARP inhibitors. Curr Opin Pharmacol. 2008;8:363–9.

    Article  PubMed  CAS  Google Scholar 

  29. Larsson SC, Mantzoros CS, Wolk A. Diabetes mellitus and risk of breast cancer: a meta-analysis. Int J Cancer. 2007;121:856–62.

    Article  PubMed  CAS  Google Scholar 

  30. Liby K, Rendi M, Suh N, et al. The combination of the rexinoid, LG100268, and a selective estrogen receptor modulator, either arzoxifene or acolbifene, synergizes in the prevention and treatment of mammary tumors in an estrogen receptor-negative model of breast cancer. Clin Cancer Res. 2006;12:5902–9.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Virginia Kaklamani M.D., D.Sc. .

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Kaklamani, V. (2013). Risk Reduction Strategies: Medical Oncology. In: Hansen, N. (eds) Management of the Patient at High Risk for Breast Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5891-3_7

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  • DOI: https://doi.org/10.1007/978-1-4614-5891-3_7

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  • Online ISBN: 978-1-4614-5891-3

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