Personalizing Prevention of Invasive Breast Cancer

By identifying women at low risk for breast cancer, resources can be redirected to high-risk women, thus lowering the incidence of breast cancer, said Jack Cuzick, PhD, on Wednesday during an educational session about breast cancer prevention. It’s a goal, he said, that should be achievable within 10 to 20 years.

Jack Cuzick, PhD,

By identifying women at low risk for breast cancer, resources can be redirected to high-risk women, thus lowering the incidence of breast cancer, said on Wednesday during an educational session about breast cancer prevention. It’s a goal, he said, that should be achievable within 10 to 20 years.

Wolfson Institute of Preventive Medicine in London, highlighted research that looked at women with dense breast tissue, which is a known risk factor. For women with dense breasts who had at least a 10 percent reduction in tissue density while taking tamoxifen, there was a 63 percent reduction in the risk of breast cancer, one study found.

Cuzick, of the

selective estrogen receptor modulators

Tamoxifen, approved for reducing breast cancer risk in women 35 and older at higher risk for breast cancer, is part of a class of drugs called SERMs (), which block the effects of estrogen. Evista (raloxifene), which is approved for reducing the risk of invasive breast cancer in postmenopausal women with osteoporosis, also belongs to this class of agents.

In addition to these approved agents, a number of other drugs are making their way through clinical testing, including a drug approved to treat HER2-positive breast cancer as well as a diabetes drug.

Journal of Clinical Oncology

Speaker Judy Garber, MD, of Dana-Farber Cancer Institute in Boston, said the therapeutic drug Tykerb (lapatinib) is currently being tested as a risk-reducing agent in women with ductal carcinoma in situ, or DCIS (stage 0 non-invasive breast cancer). For diabetics, research has shown that metformin, a drug to treat type 2 diabetes, not only lowered the rate of all cancers, but for those who did develop cancer, a study published earlier this year in the showed those patients had a better response to chemotherapy given before surgery. A phase 3 trial sponsored by the

National Cancer Institute will test whether giving metformin for five years after breast cancer treatment reduces the risk of recurrence, Garber said. The study is scheduled to start enrolling patients next year.

Other drugs of interest include the cholesterol-lowering medication fluvastatin, which is being tested in women with DCIS before surgery, and PARP inhibitors, a class of drugs getting a lot of attention in triple-negative breast cancer. A PARP inhibitor prevention study has been proposed for women who carry a BRCA mutation, said Garber.

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This article is a part of ’s 2009 San Antonio Breast Cancer Symposium coverage. To read more articles from SABCS 2009, visit .