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Breast cancer prevention by antiestrogens
1Strang Cornell Breast Center, New York, New York 10021, USA. osborne@strang.org
Annals of the New York Academy of Sciences
|February 11, 2000
Summary
Anti-estrogen medications like tamoxifen significantly cut breast cancer incidence by about 50% in high-risk women. While effective for estrogen receptor-positive and in situ cancers, potential risks like endometrial cancer were noted.
Area of Science:
- Oncology
- Endocrinology
- Pharmacology
Background:
- Breast cancer prevention is a critical area of oncology.
- Estrogen plays a key role in the development of many breast cancers.
- Antiestrogens offer a potential strategy for chemoprevention.
Purpose of the Study:
- To evaluate the efficacy of antiestrogens in preventing breast cancer.
- To assess the impact on different breast cancer subtypes and risk groups.
- To compare the effects of tamoxifen and newer selective estrogen receptor modulators (SERMs).
Main Methods:
- Landmark clinical study using tamoxifen for breast cancer prevention.
- Analysis of breast cancer incidence in pre- and postmenopausal women at increased risk.
- Evaluation of tumor characteristics, including estrogen receptor status.
- Assessment of adverse events and other health outcomes like osteoporosis and fractures.
Main Results:
- Tamoxifen reduced overall breast cancer incidence by approximately 50%.
- Significant reductions were observed in estrogen receptor-positive and in situ breast cancers.
- A collateral benefit included a significant reduction in osteoporosis-related fractures.
- Minor increases in endometrial cancer, cataracts, and stroke were noted.
Conclusions:
- Tamoxifen demonstrates significant breast cancer risk reduction in high-risk women.
- Benefits of tamoxifen appear to outweigh risks for indicated populations.
- Emerging SERMs like raloxifene show promise for breast cancer prevention with potentially fewer side effects.