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    Estrogen deprivation for breast cancer prevention.

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    Authors
    Howell, Anthony
    Clarke, Robert B
    Evans, D Gareth R
    Bundred, Nigel J
    Cuzick, Jack
    Santen, Richard J
    Allred, D Craig
    Affiliation
    CRUK Department of Medical Oncology, Christie Hospital, University of Manchester, UK.
    Issue Date
    2007
    
    Metadata
    Show full item record
    Abstract
    Estrogen deprivation (ED) either as a result of a natural or artificial menopause or the use of aromatase inhibitors in postmenopausal women results in a reduction of the incidence of breast cancer. Two major clinical trials of this approach comparing anastrozole or exemestane with placebo are currently in progress to test their efficacy for prevention. Reduction of contralateral breast lesions by at least 50% compared with tamoxifen indicate this approach has promise. The target lesion within the breast for ED is not known but we argue that hyperplastic enlarged lobular units (HELUs) as well as more advanced lesions are good candidates. A major problem for ED is de novo or acquired resistance to its effectiveness. We discuss potential mechanisms of resistance including high concentrations of tissue estrogens, increase in growth factor, and signal transduction pathways within the epithelial cell and activation of paracrine pathways from breast adipocytes, macrophages and fibroblasts. It may be possible to increase effectiveness of ED by additional preventive agents or by lifestyle alterations.
    Citation
    Estrogen deprivation for breast cancer prevention. 2007, 174:151-67 Recent Results Cancer Res.
    Journal
    Recent results in cancer research.
    URI
    http://hdl.handle.net/10541/70056
    PubMed ID
    17302193
    Type
    Article
    Language
    en
    ISSN
    0080-0015
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    All Christie Publications

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