Chemoprevention Of Breast Cancer

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[edit] Chemoprevention Of Breast Cancer

There might be a place for chemoprevention with regard to breast cancer. In a group of women who have a familial constellation for breast cancer of both breasts the anti-estrogen medication tamoxifen was used to reduce the risk of developing breast cancer in the other breast after mastectomy (surgical removal of the one breast). The risk of breast cancer in the other breast was reduced to 40% of the expected risk with this medication.

However, there are significant tamoxifen side effects and the use of it is usually limited to high-risk settings. The idea of cancer prevention utilizing hormone modulating medications is not new. In males there is an equivalent prostate cancer prevention medication, finasteride, which is medication that is used for treatment of an enlarged prostate gland. It turns out that in males this also has a significant prostate cancer prevention effect and is even effective at reduced doses that are used for male baldness treatment with finasteride. This makes it more likely that in women there would also be a useful place in certain instances for chemoprevention of breast cancer.

Other agents of interest are retinoids (=vitamin A derivatives), which have been very effective in animal experiments and are being investigated for effectiveness in humans. The aromatase inhibitor, astrozole (brand name: Arimidex), prevents the conversion of androgens from the adrenal glands being converted into estrogen substances.

This will reduce the risk for breast cancer for those cancers that have positive estrogen receptors even further. Your doctor or oncologist can advise you what medication applies to your condition.

Here is a link to a government site recommending chemoprevention of breast cancer in certain cases. This type of approach may be particularly warranted in families where there is a genetically higher risk of breast cancer, but not the high risk setting that warrants bilateral removal of the breast tissue. Discuss this with your family doctor.

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References:

The following references were used apart from my own clinical experience:

1. Cancer: Principles &Practice of Oncology, 4^th edition, by V.T. De Vita,Jr., et. al J.B. Lippincott Co.,Philadelphia, 1993. Vol.2: Chapter 48.

2. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 177.

3. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter 36: 1541-1616.

4. BS Herbert et al. Breast Cancer Res 2001;3(3):146-149.

5. BS Herbert et al. J Natl Cancer Inst 2001 Jan 3;93(1):39-45.

6. Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

7. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc