Nolvadex ®
(Tamoxifen) May Reduce Risk of Breast Cancer in High-Risk
Women
According to a recent article published in the Journal of
the National Cancer Institute, preventive therapy with Nolvadex ®
(tamoxifen) appears to significantly reduce the risk of hormone-dependent
breast cancer in a subgroup of women considered to be at high
risk for developing the disease.
Breast cancer claims the lives of approximately 40,000 women
every year in the United States alone. Researchers have been
evaluating ways to safely prevent breast cancer in order to
reduce the number of women diagnosed and subsequently killed
by breast cancer. One area of preventive research has been
in the utilization of agents to block the effects of female
hormones which have been shown to promote cellular growth
of some types (hormone-dependent) of cancer cells. Nolvadex ®
is considered an anti-estrogen, as it blocks estrogen from
its growth stimulatory effects of cancer cells, and is commonly
used in the treatment of hormone-dependent breast cancer.
Researchers have evaluated Nolvadex ® in the prevention
of breast cancer; however, the side effects associated with
this agent, particularly blood clots and uterine cancer, have
discouraged its use in a preventative setting for women in
the general population. Previous clinical studies have indicated
that certain characteristics appear to place a woman at a
higher risk for developing hormone-dependent breast cancer,
including early age of onset of menstruation, no pregnancies,
late age at first pregnancy and/or a high body mass index.
Researchers from Italy recently conducted a clinical trial
to determine if Nolvadex ® may reduce the risk of breast
cancer in women at high-risk for developing the disease. The
trial involved approximately 5,000 women who received either
Nolvadex ® or placebo (inactive substitute) between 1992
and 1997. Upon initiation of this trial, women did not have
breast cancer and had previously undergone a hysterectomy.
Half of the women in this trial had also previously had their
ovaries removed.
Overall, 34 women who had received Nolvadex ® developed
breast cancer, compared to 45 women who had received placebo.
However, in the group of patients with high-risk characteristics
including early age at onset of menstruation, no pregnancies,
late age at first pregnancies or a high body mass index were
82% less likely to develop hormone-dependent breast cancer
if they had received Nolvadex ®, compared to placebo.
These researchers concluded that women at a high-risk for
developing hormone-dependent breast cancer may benefit from
preventive therapy with Nolvadex ®. However, it is important
for these women to discuss their risk for developing breast
cancer as well as all the risks and benefits of receiving
Nolvadex ® with their physician. Future clinical trials
are warranted to determine the true clinical effectiveness
of preventive Nolvadex ® in women at a high risk for developing
hormone-dependent breast cancer. Patients with high-risk characteristics
may wish to discuss the risks and benefits of Nolvadex ®
or participation in a clinical trial evaluating preventive
strategies for breast cancer with their physician. Two sources
of information regarding ongoing clinical trials include the
National Cancer Institute ( cancer.gov) and www.eCancerTrials.com.
ECancerTrials.com also provides personalized clinical trial
searches on behalf of patients.
Reference: Veronesi U, Maisonneuve P, Rotmensz N, et al.
Italian randomized trial among women with hysterectomy: tamoxifen
and hormone-dependent breast cancer in high-risk women. Journal
of the National Cancer Institute. 2003; 95:160-165.
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