Current strategies for the prevention of breast cancer

Advani, Pooja; Moreno-Aspitia, Alvaro

doi:10.2147/bctt.s39114

Cited by 31 publications

(24 citation statements)

References 90 publications

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“…83 What are the visual consequences of such treatment? Should patients undergoing such treatment be monitored closely with regards to their ophthalmologic health?…”

Section: Discussionmentioning

confidence: 99%

Is Estrogen a Therapeutic Target for Glaucoma?

Dewundara

Wiggs

Sullivan

et al. 2016

Seminars in Ophthalmology

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Objective To provide an overview of the association between estrogen and glaucoma. Methods A literature synthesis of articles published in peer review journals screened through May 05, 2015 using the PubMed database. Key words used were “estrogen and glaucoma,” “reproductive factors and glaucoma,” “estrogen, nitric oxide and eye.” Forty three journal articles were included. Results Markers for lifetime estrogen exposure have been measured by several studies and show that the age of menarche onset, oral contraceptive (OC) use, bilateral oophorectomy, age of menopause onset and duration between menarche to menopause are associated with primary open angle (POAG) risk. The Blue Mountain Eye Study found a significantly increased POAG risk with later (>13 years) compared with earlier (≤12 years) age of menarche. Nurses’ Health Study (NHS) investigators found that OC use of greater than 5 years was associated with a 25% increased risk of POAG. The Mayo Clinic Cohort Study of Oophorectomy and Aging found that women who underwent bilateral oophorectomy before age 43 had an increased risk of glaucoma. The Rotterdam Study found that women who went through menopause before reaching the age of 45 years had a higher risk of open-angle glaucoma (2.6-fold increased risk) while the NHS showed a reduced risk of POAG among women older than 65 who entered menopause after age ≥ 54 years. Increased estrogen states may confer a reduced risk of glaucoma or glaucoma related traits such as reduced intraocular pressure (IOP). Pregnancy, a hyperestrogenemic state, is associated with decreased IOP during the third trimester. Though the role of post-menopausal hormone (PMH) use in the reduction of IOP is not fully conclusive, PMH use may reduce the risk of POAG. From a genetic epidemiologic perspective, estrogen metabolic pathway single nucleotide polymorphisms (SNPs) were associated with POAG in women and polymorphisms in endothelial nitric oxide synthase, a gene receptive to estrogen regulation, are associated with glaucoma. Conclusions Increasing evidence suggests that lifetime exposure to estrogen may alter the pathogenesis of glaucoma. Estrogen exposure may have a neuroprotective effect on the progression of POAG but further studies need to confirm this finding. The role of sex-specific preventive and therapeutic treatment may be on the horizon.

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“…83 What are the visual consequences of such treatment? Should patients undergoing such treatment be monitored closely with regards to their ophthalmologic health?…”

Section: Discussionmentioning

confidence: 99%

Is Estrogen a Therapeutic Target for Glaucoma?

Dewundara

Wiggs

Sullivan

et al. 2016

Seminars in Ophthalmology

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“…This NNT varies across other SERMS studies with the lowest being for anastrozole in the IBIS-II trial 19–21. In IBIS-11, the NNT with anastrozole to prevent one case of breast cancer in 7 years was 36 women 21. These NNTs compare favourably with interventions commonly recommended by primary care physicians; for example, the NNT is 60 persons for the use of statins for the primary prevention of myocardial infarction 22…”

Section: Discussionmentioning

confidence: 99%

Prevalence of chemopreventive agent use among hospitalised women at high risk for breast cancer: a cross-sectional study

2016

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ObjectiveTo characterise the current usage of chemoprevention agents among hospitalised women who are at higher risk for breast cancer.Study designA cross-sectional study.SettingAcademic hospital at Baltimore.ParticipantsA bedside survey of 250 women aged 50–75 years was conducted who were cancer-free at the time of study enrolment and hospitalised to a general medicine service. Reproductive history, family history for breast cancer, chemopreventive agents use and medical comorbidities data was collected for all patients. χ2 and t-tests were used to analyse population characteristics.Primary outcome measuresPrevalence of women at high risk for developing breast cancer (5-year Gail risk score ≥1.7) and their chemopreventive agent use.ResultsMean age for the study population was 61.5 years (SD 7.5), and mean 5-year Gail risk score was 1.67 (SD 0.88). A third of study population was at high risk for breast cancer. None of the high-risk women (0%) were taking chemoprevention for breast cancer risk reduction, and 23% were at very high risk with 5-year Gail score ≥3%. These women were not recognised as being high risk by their hospital providers and none were referred to the high-risk breast cancer clinics following discharge.ConclusionsMany hospitalised women are at high risk for breast cancer and we could not identify even a single woman who was using chemoprevention for risk reduction. Current chemoprevention guidelines may be falling short in their dissemination and implementation. Since women at high risk for breast cancer may only interface with the healthcare system at select points, all healthcare providers must be willing and able to do risk assessment. For those identified to be at high risk, providers must then either engage in chemopreventive counselling or refer patients to providers who are more comfortable working with patients on this critical decision.

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“…Several breast cancer risk factors have been identified, and estrogen exposure is one example. 24,25 Although our study involved a relatively short observational period, we note that there were no recurrent breast cancer patients among patients given FP with letrozole. This result suggested that ovarian stimulation with letrozole does not have a great influence on the recurrence rate for breast cancer during at least short periods; this is consistent with the results of a previous study that followed patients for a longer time period.…”

Section: Fps (N = 29) Lps (N = 21) Pmentioning

confidence: 97%

Random‐start ovarian stimulation with aromatase inhibitor for fertility preservation in women with Japanese breast cancer

Nakasuji

Kawai

Ishikawa

et al. 2019

Reprod Medicine & Biology

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Purpose Fertility preservation is an important issue for young cancer patients. Random‐start controlled ovarian stimulation and double ovarian stimulation have been proposed for efficient oocyte retrieval within the limited time before cancer therapy. We aimed to clarify the efficacy of these new protocols within the Japanese population. Methods We performed a retrospective observational study at a multicenter from February 2012 to August 2017. The study entailed 50 cycles with 34 patients who underwent fertility preservation due to breast cancer. Follicular phase or luteal phase ovarian stimulation with aromatase inhibitor was performed. A second ovarian stimulation was started with or without waiting until the next menstruation. We measured the number of retrieved oocytes and cryopreserved oocytes/embryos, the ratio of mature oocytes, and the fertilization rate. Results The numbers of retrieved oocytes and frozen oocytes/embryos were not significantly different between follicular phase and luteal phase ovarian stimulation. The number of retrieved oocytes was not reduced at the second ovum pick up compared to the first ovum pick up in the double ovarian stimulation. Conclusions Random‐start controlled ovarian stimulation and double ovarian stimulation with aromatase inhibitor for breast cancer patients were effective protocols for retrieving a greater number of oocytes within the limited time.

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Current strategies for the prevention of breast cancer

Cited by 31 publications

References 90 publications

Is Estrogen a Therapeutic Target for Glaucoma?

Is Estrogen a Therapeutic Target for Glaucoma?

Prevalence of chemopreventive agent use among hospitalised women at high risk for breast cancer: a cross-sectional study

Random‐start ovarian stimulation with aromatase inhibitor for fertility preservation in women with Japanese breast cancer

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