"If you don't prevent people from dying, then how valuable is that? " - Professor Mike Dixon questioning the benefit of chemoprevention. This week at the Annual Miami Breast Cancer Conference, Professor Mike Dixon questioned the value of tamoxifen as a breast cancer chemopreventative – that is taking the drug before breast cancer develops to reduce the risk of it occurring. In June 2013, the National Institute for Health and Care Excellence (NICE) recommended for the first time that two drugs, tamoxifen and raloxifene, should be made available on the NHS in England and Wales for women at increased risk of developing breast cancer. This was widely heralded as a game-changer by Breakthrough and other charities. Two years later and questions are starting to be asked – has chemoprevention lived up to its promise? There is clear evidence that tamoxifen, long used as a breast cancer treatment, can also reduce the risk of a breast cancer developing in the first place. Based on data from the phase III TAM-01 trial presented at the 41st Annual San Antonio Breast Cancer Symposium (SABCS), investigators concluded that giving women diagnosed with breast intraepithelial neoplasia (IEN) a lower dose of tamoxifen following surgery could be as effective and less toxic than the current standard dose. “We know tamoxifen is effective in prevention, but its toxicity…represents an important barrier for its use in a population at increased risk for breast cancer.” said Andrea De Censi, MD, director of the medical oncology unit at the National Hospital E. Ospedali Galliera–SC Oncologia Medica in Genoa, Italy, who presented the findings at the meeting. The current standard for tamoxifen therapy following surgical removal for this patient population is 20 mg daily for 5 years. However, patient compliance is often an issue due to its toxicity profile. “It is not clear what is the minimal active dose to illicit its biological and clinical effect,” De Censi said. Study investigators hypothesized that a lower dose of tamoxifen over a shorter duration could be equally as effective yet less toxic than the current stand dose. The annual risk of events was calculated to be 11.6 versus 23. patients, representing a 52% reduction in the cumulative risk of disease. The risk of contralateral breast cancer with low-dose tamoxifen was reduced by 75% when compared with placebo (HR 0.24; 95% CI, 0.07-0.87; = .018), suggesting a strong preventative potential.
Early Breast Cancer Trialists’ Collaborative Group. Fisher and coworkers reported that women given tamoxifen for only 5 years for ER-positive breast cancer with negative nodes had improved disease-free survival compared with women randomized to continue tamoxifen more than 5 years (92% vs 86% respectively, P=.003). The optimal duration of treatment for primary prevention has not been determined. Breast cancers in women with the Breast Cancer 1 gene (BRCA1) are more likely to be ER negative. Authors estimated that 36% of participants and 60% of women who developed breast cancer had a greater than 80% chance of having a breast cancer predisposition gene. HRT was allowed, and the study had 90% power to detect a reduction of 50% in breast cancer incidence. Powles and colleagues reported no benefit from tamoxifen in young women with at least one first-degree relative with breast cancer. reported no overall benefit from treatment with tamoxifen in low-risk hysterectomized women, but the trial was underpowered, had a high dropout rate in the first year, and allowed hormone replacement therapy (HRT). If you are on a personal connection, like at home, you can run an anti-virus scan on your device to make sure it is not infected with malware. If you are at an office or shared network, you can ask the network administrator to run a scan across the network looking for misconfigured or infected devices. Another way to prevent getting this page in the future is to use Privacy Pass. Check out the browser extension in the Chrome Store.
Breast cancer treatment can be a long, demanding process, and it can take a toll on you in many ways. By the end of it all, you've gone through a tremendous journey that has tested you physically, mentally, emotionally and, perhaps, spiritually. How does being a breast cancer survivor really affect the rest of your life? But once yo surgery, chemotherapy and radiation treatment, the next logical thing to do is to get back to living your life as you knew it, right? The truth is, you might never feel completely the same, live life the same way or be the same person you were before your diagnosis. Read More Enter the code BCP and receive $5.00 off your purchase of either the 4-oz ($14.99) or 8-oz ($24.99) size of the AWA Pure African Shea Butter. Click on 4 oz 100% Pure Shea Butter or 8 oz 100% Pure Shea Butter to place your order. The New You: Coping with Physical Changes after Treatment Breast cancer risk factors and prevention Exercise May Boost Breast Cancer Patients' Quality of Life Study finds lingering pain, swelling, fatigue, mobility problems in many women. Evista isn't used to treat breast cancer after it's been diagnosed. Evista also won't work on hormone-receptor-negative breast cancer. Evista is a pill that is taken once per day, with or without food. Ask your doctor which type of non-hormonal birth control would be best for you, as well as how long you should use this type of birth control after you stop taking Evista. Most doctors recommend taking Evista at the same time every day. The large STAR (Study of Tamoxifen and Raloxifene) trial compared Evista and tamoxifen, another SERM, to see if one medicine was better than the other at reducing the risk of invasive breast cancer in postmenopausal women. You should not take Evista if you are breastfeeding, pregnant, trying to get pregnant, or if there is any chance that you could be pregnant. You should use an effective non-hormonal type of birth control -- such as condoms, a diaphragm along with spermicide, or a non-hormonal I. The researchers also looked at whether postmenopausal women who took Evista or tamoxifen had similar quality of life. STAR trial results showed that Evista and tamoxifen offer the same reduction in risk -- both medicines lower the risk of invasive breast cancer by about 50%. Both medicines also offer the same overall quality of life.
When are hormone therapies used? Some breast cancer cells need estrogen and/or progesterone female hormones produced in the body to grow. When these hormones attach to special proteins called hormone receptors, the cancer cells with these receptors grow. Evista chemical name raloxifene is a SERM approved by the U. S. Food and Drug Administration FDA to reduce the risk of hormone-receptor-positive breast cancer in postmenopausal women who haven't been diagnosed but are at higher-than-average risk for disease