The tamoxifen prevention trials showed a 38% reduction of breast cancer incidence. The evidence clearly shows that tamoxifen can reduce the risk of estrogen receptor (ER)-positive breast cancer. New approaches are needed to prevent ER-negative breast cancer and to reduce tamoxifen's adverse events, including a lower dose of tamoxifen. Different strategies are being pursued to improve the riskibenefit ratio of breast cancer chemoprevention. Raloxifen is being compared with tamoxifen in a phase III trial and the minimal active dose of tamoxifen is being assessed in phase I-II trials. The effect of the combination of hormone replacement therapy and tamoxifen is studied in order to reduce the risk while retaining the benefit of either agent. Anastrozole holds promise as a preventive agent based on preliminary data on contralateral breast cancer. An appropriated identification of women at increased risk for ER-positive breast cancer due to reproductive factors may maximize the therapeutic index of hormonal agents. Finally, new targets that interfere with ER-negative breast carcinogenesis are being sought as one-third of breast cancers will not be preventable by hormonal interventions.
|Number of pages||8|
|Journal||CME Journal of Gynecologic Oncology|
|Publication status||Published - Jul 2004|
- Breast neoplasms
- Clinical trial
ASJC Scopus subject areas
- Obstetrics and Gynaecology