Tamoxifen and contralateral breast cancer in <i>BRCA1</i> and <i>BRCA2</i> carriers: An update

Gronwald, Jacek; Tung, Nadine; Foulkes, William D.; Offit, Kenneth; Gershoni, Ruth; Daly, Mary B.; Kim-Sing, Charmaine; Olsson, Håkan; Ainsworth, Peter; Eisen, Andrea; Saal, Howard M.; Friedman, Eitan; Olopade, Olufunmilayo I.; Osborne, Michael P.; Weitzel, Jeffrey N.; Lynch, Henry T.; Ghadirian, Parviz; Lubiński, Jan; Sun, Ping; Narod, Steven A.

doi:10.1002/ijc.21536

Cited by 234 publications

(134 citation statements)

References 21 publications

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“…Tamoxifen has been associated with a reduction in second primary breast cancer in BRCA1 or BRCA2 mutation carriers, and nonadherence in this setting is associated with a young age (<40 years; refs. 34,35). Of interest, smoking (36) and young age (37) have been associated with nonadherence to breast cancer screening.…”

Section: Healthy High Risk/preventionmentioning

confidence: 99%

Predicting Adherence to Tamoxifen for Breast Cancer Adjuvant Therapy and Prevention

Zhang

Manson

2011

Cancer Prevention Research

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Treatment with the selective estrogen receptor modulator (SERM) tamoxifen for 5 years has produced dramatic breast cancer-related benefits in (a) the adjuvant setting, with 30% to 50% reductions in recurrence, contralateral disease, and mortality and (b) the prevention setting of healthy high-risk women, where tamoxifen reduces the risk of invasive and noninvasive breast cancer by 50%. Despite these striking data, adherence to tamoxifen is low, and low adherence is associated with poor survival. Although toxicity is a major predictor of poor adherence after starting therapy, pretreatment (baseline) predictors of poor tamoxifen adherence have been minimally studied. The adherence-survival link underscores the critical need to identify early predictors of poor adherence, and recent work is beginning to address this need. A major baseline predictor of poor adherence to prevention is current smoking, which is interestingly absent from studies of adherence to adjuvant therapy. Other important prevention adherence factors include breast cancer risk, extremes of age, non-white ethnicity, low socioeconomic status, and alcohol use. The strongest adjuvant therapy predictors are age (especially very young), ethnicity, and socioeconomic status. Future studies involving prospective systematic evaluation of these and other potential predictors in endocrine chemoprevention (e.g., other SERMs and aromatase inhibitors) are critical, as is the development of effective/targeted interventions to improve adherence and thus treatment outcomes in at-risk women.

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Section: Healthy High Risk/preventionmentioning

confidence: 99%

Predicting Adherence to Tamoxifen for Breast Cancer Adjuvant Therapy and Prevention

Zhang

Manson

2011

Cancer Prevention Research

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“…The effect of tamoxifen on contralateral breast cancer has been studied in a case-control study of BRCA1 and BRCA2 mutation carriers (Gronwald et al, 2006). The multivariate OR for contralateral breast cancer associated with tamoxifen use was 0.50 for carriers of BRCA1 mutations (95% CI: 0.30-0.85) and was 0.42 for carriers of BRCA2 mutations (95% CI: 0.17-1.02), implying a risk reduction of 50% or more.…”

Section: Tamoxifen and Raloxifenementioning

confidence: 99%

Modifiers of risk of hereditary breast cancer

Narod

2006

Oncogene

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Mutations in the BRCA1 and BRCA2 genes confer a high lifetime risk of breast and ovarian cancer. The risk varies from individual to individual, and it appears that the risk has increased in recent generations. These observations imply that non-genetic factors may modify the inherited risk. To date, the factors that appear most strongly to modify the risk include reproductive histories and exogenous hormones. Oral contraceptives are associated with a profound reduction in the risk of ovarian cancer, and with little or no increase in the risk of breast cancer. Other modifying factors include age of menarche, parity, breastfeeding and oophorectomy. The effect of parity is different in BRCA1 and BRCA2 carriers. Multiparity appears to be protective in BRCA1 carriers, but is associated with an increase in risk in BRCA2 carriers. Oophorectomy has been associated with reductions in both the risk of breast and ovarian cancer. Knowledge of these risk factors will be useful for managing risk and for developing prevention strategies.

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“…El-Harith et al concluded from their study that BRCA1 and BRCA2 mutations are likely to contribute to the pathogenesis of familial BC in Saudi Arabia (El Harith et al, 2002). Women at high risk would benefit from genetic counseling that helps patients or family members make informed decisions about genetic testing and that enhances selection of early cancer detection and/or risk-reduction strategies (The United States Preventive Services Task Force 2005 and the National Comprehensive Cancer Network 2008; Schwartz GF et al 2008;Gronwald J et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Saudi Women's Interest in Breast Cancer Gene Testing: Possible Influence of Awareness, Perceived Risk and Socio-demographic Factors

Amin¹,

Al-Wadaani²,

Al-Quaimi³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Background: Development of effective educational strategies should accompany increases in public awareness and the availability of genetic testing for breast cancer (BC). These educational strategies should be designed to fulfill the knowledge gap while considering factors that influence women's interest in order to facilitate decision making. Objective: To determine the possible correlates of Saudi women's interest in BC genes testing including socio-demographics, the level of awareness towards BC genes, the family history of BC and the perceived personal risk among adult Saudi women in Al Hassa, Saudi Arabia. Subjects and methods: This cross-sectional study was carried out during the second BC community-based campaign in Al Hassa, Saudi Arabia. All Saudi women aged ≥ 18 years (n=781) attending the educational components of the campaign were invited to a personal interview. Data collection included gathering information about sociodemographics, family history of BC, the perceived personal risk for BC, awareness and attitude towards BC genes and the women's interest in BC genes testing. Results: Of the included women (n=599), 19.5% perceived higher risk for BC development, significantly more among < 40 years of age, and with positive family history of BC before 50 years of age. The participants demonstrated a poor level of awareness regarding the inheritance, risk, and availability of BC genetic testing. The median summated knowledge score was 1.0 (out of 7 points) with a knowledge deficit of 87.8%. The level of knowledge showed significant decline with age (> 40 years). Of the included women 54.7% expressed an interest in BC genetic testing for assessing their BC risk. Multivariate regression model showed that being middle aged (Odds Ratio 'OR'=1.88, confidence intervals 'C.I'=1.14-3.11), with higher knowledge level (OR=1.67, C.I=1.08-2.57) and perceiving higher risk for BC (OR=2.11, C.I=1.61-2.76) were the significant positive correlates for Saudi women interest in BC genetic testing. Conclusion: Saudi women express high interest in genetic testing for BC risk despite their poor awareness. This great interest may reflect the presence of inappropriate information regarding BC genetic testing and its role in risk analysis.

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Tamoxifen and contralateral breast cancer in BRCA1 and BRCA2 carriers: An update

Cited by 234 publications

References 21 publications

Predicting Adherence to Tamoxifen for Breast Cancer Adjuvant Therapy and Prevention

Predicting Adherence to Tamoxifen for Breast Cancer Adjuvant Therapy and Prevention

Modifiers of risk of hereditary breast cancer

Saudi Women's Interest in Breast Cancer Gene Testing: Possible Influence of Awareness, Perceived Risk and Socio-demographic Factors

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