Chemoprevention for Breast Cancer

Abstract

BackgroundMany women at increased risk for breast cancer could benefit from preventive therapy. Preventive therapy options for breast cancer risk reduction have expanded in the last few years to include both selective receptor modulators (tamoxifen and raloxifene) and aromatase inhibitors (anastrozole and exemestane).MethodsRisk factors that place women at high risk for breast cancer, as well as risk calculation models appropriate for the selection of candidates for preventive therapy, are presented, followed by a review of current guidelines for chemoprevention and results of chemoprevention trials.ResultsThe modified Gail model or Breast Cancer Risk Assessment Tool is the most widely utilized risk assessment calculator to determine eligibility for chemoprevention. Women most likely to benefit from preventive therapy include those at high risk under the age of 50 years and those with atypical hyperplasia. Physician and patient barriers limit widespread acceptance and adherence to preventive therapy.ConclusionsPublished guidelines on chemoprevention for breast cancer have been updated to increase awareness and encourage discussion between patients and their physicians regarding evidence-based studies evaluating the benefits of preventive options for women at increased risk for breast cancer. However, even with increasing awareness and established benefits of preventive therapy, the uptake of chemoprevention has been low, with both physician and patient barriers identified. It is prudent that these barriers be overcome to enable high-risk women with a favorable risk-to-benefit ratio to be offered chemoprevention to reduce their likelihood of developing hormone receptor-positive breast cancer.

Breast Cancer Profile among Patients with a History of Chemoprevention

“…This is likely due to the fact that endocrine therapies are ineffective in triple negative cancers and these tumors are associated with poor prognosis [17]. An additional etiology of these findings could be related to the barriers which limit use of and compliance with chemoprevention, including side effects and physician challenges to recruit eligible women [18]. Our findings echo these results in our secondary chemoprevention cohort.…”

Hereditary breast and ovarian cancer: risk assessment in minority women and provider knowledge gaps

“…7 For women who test positive for a BRCA 1/2 mutation, interventions that include chemoprevention, enhanced surveillance, or prophylactic mastectomy and salpingo-oophorectomy can decrease the incidence of breast and ovarian cancer by up to 95% and 80%, respectively. [9][10][11][12][13] Despite these clear benefts, the literature demonstrates under-referral to and under-use of genetic counseling and testing, particularly for minority and underserved women. Racial/ethnic minorities include African Americans, Hispanics, and Asians.…”

El vendaje cohesivo en el tratamiento de la trombosis linfática superficial en mujeres intervenidas de cáncer de mama. Serie de casos

“…El anastrozol, incluye además síndrome del túnel carpiano. Con relación a la calidad de vida, no se han encontrado diferencias estadísticamente significativas entre el tamoxifeno y los IA (8,33,34,36).…”