Prevention of breast cancer

The initial results of three tamoxifen studies in the prevention of breast cancer in 'high-risk' well women are controversial. An American study has shown a significant reduction in breast cancer with tamoxifen, but a UK and an Italian study have not confirmed this. The groups of women in each study were different, and it may be that the US study was positive because of the preponderance of older women (in whom tamoxifen may be more effective).

Fenretinide, a derivative of retinoic acid, appears a good candidate for chemoprevention as it has been shown to reduce the risk of contralateral and ipsilateral breast carcinomas in menopausal women. Other agents such as raloxifene have also shown promise.

1. Early Breast Cancer Trialists' Collaborative Group. (1992) Systemic treatment of early breast cancer by hormonal, cytotoxic or immune therapy—Parts I and II. Lancet 339,1-15,71-85.

2. Early Breast Cancer Trialists' Collaborative Group. (1998) Tamoxifen for early breast cancer: an overview of the randomized trials. Lancet 351, 1451-67.

3. Early Breast Cancer Trialists' Collaborative Group. (1998) Polychemotherapy for early breast cancer: an overview of the randomized trials. Lancet 352,930-42.

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