scholarly journals Benefit/Risk Assessment for Breast Cancer Chemoprevention With Raloxifene or Tamoxifen for Women Age 50 Years or Older

2011 ◽  
Vol 29 (17) ◽  
pp. 2327-2333 ◽  
Author(s):  
Andrew N. Freedman ◽  
Binbing Yu ◽  
Mitchell H. Gail ◽  
Joseph P. Costantino ◽  
Barry I. Graubard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Outcomes ◽  
Postmenopausal Women ◽  
Risk Index ◽  
Cancer Chemoprevention ◽  
Incidence Rates ◽  
Net Benefit ◽  
Risks And Benefits ◽  
Benefit Risk Assessment ◽  
Breast Cancer Chemoprevention

Purpose The Study of Tamoxifen and Raloxifene (STAR) demonstrated that raloxifene was as effective as tamoxifen in reducing the risk of invasive breast cancer (IBC) in postmenopausal women and had lower risks of thromboembolic events, endometrial cancer, and cataracts but had a nonstatistically significant higher risk of noninvasive breast cancer. There is a need to summarize the risks and benefits of these agents. Patients and Methods Baseline incidence rates of IBC and other health outcomes, absent raloxifene and tamoxifen, were estimated from breast cancer chemoprevention trials; the Surveillance, Epidemiology and End Results Program; and the Women's Health Initiative. Effects of raloxifene and tamoxifen were estimated from STAR and the Breast Cancer Prevention Trial. We assigned weights to health outcomes to calculate the net benefit from raloxifene compared with placebo and tamoxifen compared with placebo. Results Risks and benefits of treatment with raloxifene or tamoxifen depend on age, race, breast cancer risk, and history of hysterectomy. Over a 5-year period, postmenopausal women with an intact uterus had a better benefit/risk index for raloxifene than for tamoxifen. For postmenopausal women without a uterus, the benefit/risk ratio was similar. The benefits and risks of raloxifene and tamoxifen are described in tables that can help identify groups of women for whom the benefits outweigh the risks. Conclusion We developed a benefit/risk index to quantify benefits from chemoprevention with tamoxifen or raloxifene. This index can complement clinical evaluation in deciding whether to initiate chemoprevention and in comparing the benefits and risks of raloxifene versus tamoxifen.

scholarly journals Baseline estrogen levels in postmenopausal women participating in the MAP.3 breast cancer chemoprevention trial

Menopause ◽  
2020 ◽  
Vol 27 (6) ◽  
pp. 693-700
Author(s):  
Harriet Richardson ◽  
Vikki Ho ◽  
Romain Pasquet ◽  
Ravinder J. Singh ◽  
Matthew P. Goetz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postmenopausal Women ◽  
Cancer Chemoprevention ◽  
Breast Cancer Chemoprevention ◽  
Chemoprevention Trial

scholarly journals Personalizing Aspirin Use for Targeted Breast Cancer Chemoprevention in Postmenopausal Women

2016 ◽  
Vol 91 (1) ◽  
pp. 71-80 ◽  
Author(s):  
Aditya Bardia ◽  
Tanya E. Keenan ◽  
Jon O. Ebbert ◽  
DeAnn Lazovich ◽  
Alice H. Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postmenopausal Women ◽  
Cancer Chemoprevention ◽  
Breast Cancer Chemoprevention

Chemoprevention for Breast Cancer: Overcoming Barriers to Treatment

2012 ◽  
pp. 85-90 ◽  
Author(s):  
Abenaa M. Brewster ◽  
Nancy E. Davidson ◽  
Worta McCaskill-Stevens
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Randomized Clinical Trials ◽  
Cancer Chemoprevention ◽  
The United States ◽  
Develop Breast Cancer ◽  
Net Benefit ◽  
Eligibility Criteria ◽  
High Risk Women ◽  
Breast Cancer Chemoprevention

Overview: Evidence from placebo-controlled, randomized clinical trials supports the use of chemoprevention in women at high risk for developing breast cancer, and two agents—tamoxifen and raloxifene—are U.S. Food and Drug Administration (FDA)-approved for the indication. Despite clinical guidelines that recommend physicians counsel high-risk women about the use of chemoprevention and the estimated 2.4 million women in the United States who meet eligibility criteria for net benefit, the uptake of breast cancer chemoprevention has been exceedingly low. Assessments of the risks and benefits of chemoprevention are aided by the availability of models that can be used to estimate of the risk–benefit ratio. However, many physicians remain unaware of these resources to determine patient eligibility for chemoprevention and lack the time to provide informed counseling to their patients. The barriers for patients' acceptance of chemoprevention treatment include fear of side effects and the perception that chemoprevention will not substantially lower their risk of developing breast cancer. Despite these challenges, there are substantial opportunities to increase the utilization of chemoprevention. These strategies include education, dissemination of user-friendly risk–benefit models, and the support of research efforts focused on identifying biomarkers that can more accurately select women most likely to develop breast cancer and predict responsiveness of treatment.

scholarly journals Methylseleninic acid is a novel suppressor of aromatase expression

2011 ◽  
Vol 212 (2) ◽  
pp. 199-205 ◽  
Author(s):  
Ruijuan Gao ◽  
Lijuan Zhao ◽  
Xichun Liu ◽  
Brian G Rowan ◽  
Martin Wabitsch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postmenopausal Women ◽  
Aromatase Inhibitors ◽  
Low Cost ◽  
Cancer Chemoprevention ◽  
Chemopreventive Agents ◽  
First Line Therapy ◽  
Methylseleninic Acid ◽  
Estrogen Receptor Positive ◽  
Breast Cancer Chemoprevention

Elevated circulating estrogen levels, as a result of increased peripheral aromatization of androgens by aromatase, have been indicated to underlie the association between obesity and a higher risk of breast cancer in postmenopausal women. Although aromatase inhibitors have been used as a first-line therapy for estrogen receptor-positive breast cancer in postmenopausal women, their potential as breast cancer chemopreventive agents has been limited due to toxicities and high costs. It is therefore imperative to develop new aromatase-inhibiting/suppressing agents with lower toxicities and lower costs for breast cancer chemoprevention, especially in obese postmenopausal women. The expression of the aromatase gene,CYP19, is controlled in a tissue-specific manner by the alternate use of different promoters. In obese postmenopausal women, increased peripheral aromatase is primarily attributed to the activity of the glucocorticoid-stimulated promoter, PI.4, and the cAMP-stimulated promoter, PII. In the present study, we show that methylseleninic acid (MSA), a second-generation selenium compound, can effectively suppress aromatase activation by dexamethasone, a synthetic glucocorticoid, and forskolin, a specific activator of adenylate cyclase. Unlike the action of aromatase inhibitors, MSA suppression of aromatase activation is not mediatedviadirect inhibition of aromatase enzymatic activity. Rather, it is attributable to a marked downregulation of promoters PI.4- and PII-specific aromatase mRNA expression, and thereby a reduction of aromatase protein. Considering the low-cost and low-toxicity nature of MSA, our findings provide a strong rationale for the further development of MSA as a breast cancer chemopreventive agent for obese postmenopausal women.

Spices with Breast Cancer Chemopreventive and Therapeutic Potentials: A Functional Foods Based-Review

2018 ◽  
Vol 18 (2) ◽  
pp. 182-194 ◽  
Author(s):  
Aliyu Muhammad ◽  
Mohammed Auwal Ibrahim ◽  
Ochuko Lucky Erukainure ◽  
Ibrahim Malami ◽  
Auwal Adamu
Keyword(s):  
Breast Cancer ◽  
Urban Areas ◽  
Cancer Chemoprevention ◽  
Biologically Active ◽  
Active Metabolites ◽  
Rural And Urban Areas ◽  
Anticancer Properties ◽  
Rural And Urban ◽  
Breast Cancer Chemoprevention ◽  
Biologically Active Metabolites

Background: Cancer is a multifaceted metabolic disease that affects sizeable dwellers of rural and urban areas. Among the various types of cancer, mammary cancer is one of the most frequently diagnosed cancers in women. Its menace can be curbed with locally consumed spices due to their multiple bioactive phytochemicals. Aims: This review focuses on the breast cancer chemopreventive and therapeutic potentials of locally consumed spices. Methods/Results: The most commonly consumed spices with breast cancer chemopreventive and chemotherapeutic phytochemical include pepper, onions, ginger, garlic, curry and thyme containing many biologically active metabolites ranging from vitamins, fatty acids esters, polyphenols/phenolics, sulfurcontaining compounds and anthraquinones with proven antioxidant, anti-inflammatory, immuno-modulatory, antitumor and anticancer properties against breast cancer/carcinogenesis. Therefore, extracts and active principles of these spices could be explored in breast cancer chemoprevention and possibly therapeutically which may provide an avenue for reducing the risk and prevalence of breast cancer.

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