Chemoprevention of Breast Cancer

  • Ruth M. O’Regan
Part of the Cancer Treatment and Research book series (CTAR, volume 103)

Abstract

One in eight women in the United States will develop breast cancer. Family history, hormonal factors and benign breast disease have been identified as key factors in the development of breast cancer. Until recently the only treatment option for women identified as being at high risk of developing breast cancer was bilateral prophylactic mastectomy. Tamoxifen is the treatment of choice for patients with all stages of hormone-responsive breast cancer. Tamoxifen has a proven safety record from analysis of its use in patients with early stage breast cancer and, in postmenopausal women, it maintains bone density and lowers cholesterol levels. Lastly, tamoxifen reduces the incidence of contralateral breast cancer in women with breast cancer. Recently, in a large randomized trial where women at high risk of breast cancer were randomized to tamoxifen or placebo, tamoxifen resulted in a 50% reduction in the incidence of both invasive and non-invasive breast cancers. On the basis of this result, tamoxifen has been approved as a preventive for women at high risk of developing breast cancer. The optimum duration of tamoxifen in the preventive setting is to date unclear, but in the adjuvant setting, tamoxifen continues to have beneficial effects even after it is stopped. Tamoxifen does result in a two- to threefold increase in endometrial cancer, and new antiestrogens, such as raloxifene, are being developed to reduce this risk. The next prevention trial, called Study of Tamoxifen and Raloxifene (STAR), will randomize postmenopausal women to tamoxifen or raloxifene for five years.

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Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Ruth M. O’Regan
    • 1
  1. 1.Division of Hematology/Oncology Robert H. Lurie Comprehensive Cancer CenterNorthwestern UniversityUSA

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