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Breast cancer prevention with selective estrogen receptor modulators: a perspective
1Division of Clinical Trials and Epidemiology, Toronto-Sunnybrook Regional Cancer Centre, Ontario, Canada. kathy.pritchard@tsrcc.on.ca
Annals of the New York Academy of Sciences
|January 25, 2002
Summary
Tamoxifen significantly reduces breast cancer incidence, particularly estrogen receptor-positive tumors, in high-risk women. Newer drugs like raloxifene show promise but require further study for breast cancer prevention.
Area of Science:
- Oncology
- Pharmacology
- Preventive Medicine
Background:
- Early ovarian ablation reduces premenopausal breast cancer.
- Tamoxifen demonstrated a significant reduction in contralateral breast cancer incidence.
Purpose of the Study:
- To evaluate tamoxifen's efficacy in reducing breast cancer incidence in high-risk women.
- To assess the preventive potential of raloxifene for breast cancer.
Main Methods:
- The National Surgical Adjuvant Breast and Bowel Project (NSABP) conducted a randomized trial comparing tamoxifen and placebo.
- The Study of Tamoxifen and Raloxifene (STAR) is comparing tamoxifen and raloxifene in postmenopausal women.
Main Results:
- Tamoxifen reduced both ductal carcinoma in situ (DCIS) and invasive breast cancer incidence in women aged 35+ at increased risk.
- The reduction in incidence was observed across all study years and subgroups of high-risk women.
- All observed benefits of tamoxifen were limited to estrogen receptor (ER)-positive tumors.
Conclusions:
- Tamoxifen is an effective chemoprevention strategy for high-risk women, particularly for ER-positive breast cancers.
- Further research, including the STAR study, is needed to determine optimal breast cancer prevention strategies involving tamoxifen, raloxifene, and other agents.