Current status of breast cancer chemoprevention.
DOI:
https://doi.org/10.35954/SM2005.27.1.8Keywords:
Breast cancer; Chemoprevention; Tamoxifen.Abstract
Introduction: Since the observation that patients receiving adjuvant hormone therapy based on tamoxifen showed a 39% decrease in the incidence of contralateral breast cancer, the benefit of its use with chemopreventive criterion was proposed. The feasibility of this strategy was confirmed and multiple studies were initiated to confirm the benefit of chemopreventive treatment, the target population and its toxicity profile.
Objective: To analyze the studies published to date on chemoprevention in breast cancer, the recommendations made and to outline the main indications for chemoprevention that could be applied in our setting.
Discussion: Of the works published on chemoprevention in breast cancer to date, the most studied drug is Tamoxifen. The NSABP-P1 study stands out as the best designed study, with the largest number of patients. Of all the recommendations presented, there is agreement on the delimitation of a population that would benefit from chemopreventive treatment based on tamoxifen. Treatment based on Tamoxifen 20 mg/d for 5 years with preventive criteria should be indicated after an individual and informed assessment of the benefit/risk ratio of the patient we are dealing with. All recommendations coincide in the indication of this treatment for patients with a history of lobular carcinoma in situ (LCIS), atypical hyperplasia or who have 2 or more first-degree relatives with breast cancer.
The benefit is clear in patients younger than 50 years and older than 50 years with hysterectomy without thromboembolic risk factors.
Article Received: July 6, 2004.
Article accepted: November 8, 2004.
Correspondence address Dr. Robinson Rodríguez. Clinical Oncology Service - Hospital de Clínicas Avda. Italia s/n. PB.
Telefax: 487 2075.
E-mail: rrodri@hc.edu.uy
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