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Meta-Analysis
Published in Trevor F. Cox, Medical Statistics for Cancer Studies, 2022
The review looked at the efficacy of breast cancer prevention agents (CPAs) for the prevention of primary breast cancer in women with above average risk of developing the disease. Toxicity of CPAs was also considered. The literature was searched and after starting with 2,717 records, only six were left after review for a quantitative analysis. The six studies used the treatments: Tamoxifen, Raloxifene, Exemestane, Anastrozole and Placebo in head-to-head comparisons, the main outcomes of interest being: overall breast cancer incidence, invasive breast cancer incidence and severe toxicity. Within a study, comparison between arms is made using relative risk.
A Lifestyle Medicine Approach to Breast Cancer
Published in Michelle Tollefson, Nancy Eriksen, Neha Pathak, Improving Women's Health Across the Lifespan, 2021
Amber Orman, Dianne L. Johnson, Amy Comander, Nigel Brockton, Meghana Reddy, Gautam Krishna Koipallil
Breast cancer is the most common female cancer in the United States (aside from skin cancer), with over 275,000 cases estimated in 2020.1 Improvements in early detection and advances in treatment have resulted in 5-year survival rates reaching approximately 90%. However, breast cancer remains the second leading cause of female cancer death in America, with over 42,000 deaths per year.1 Fortunately, a substantial body of research indicates that several modifiable lifestyle factors can significantly reduce the risk of breast cancer3 and adherence to lifestyle recommendations after a diagnosis can improve cancer-related health outcomes.4 This chapter will review our current understanding of the role of lifestyle in both primary and tertiary breast cancer prevention as well as breast cancer treatment.
Chemoprevention of breast cancer with tamoxifen: recent experience and future perspectives
Published in A. R. Genazzani, Hormone Replacement Therapy and Cancer, 2020
B. Bonanni, A. Guerrieri-Gonzaga, N. Rotmensz, A. Decensi
Tamoxifen is a non-steroidal triphenylethylene derivative which can be classified as a first-generation selective estrogen receptor modulator (SERM)1,2. It is widely used for palliative endocrine treatment of advanced breast cancer and as adjuvant therapy to control micrometastatic relapse and new primaries in women treated surgically for early breast cancer2. Tamoxifen has also been investigated in three large cooperative phase III trials for breast cancer prevention in at-risk women. While the preliminary results of two European studies, conducted in Italy (Italian Tamoxifen Prevention Study) and the UK (Royal Marsden Tamoxifen Chemoprevention Trial), have shown no significant difference so far3,4, the American trial (National Surgical Adjuvant Breast and Bowel Project, NSABP-P1) has shown a 50% reduction in the risk of both invasive and noninvasive breast cancer and a 69% reduction in the occurrence of estrogen receptor-positive tumors5.
Adherence to Oxidative Balance Scores is Associated with a Reduced Risk of Breast Cancer; A Case-Control Study
Published in Nutrition and Cancer, 2022
Mohammad Hassan Sohouli, Mansoureh Baniasadi, Ángela Hernández-Ruiz, Ebru Melekoglu, Mona Zendehdel, María José Soto-Méndez, Atieh Akbari, Mitra Zarrati
This research may help improve the understanding of the beneficial effects of the combination of dietary components and lifestyle factors associated with the possible prevention of BrCa by focusing on reducing oxidative stress. Based on our results, the combination of a high intake of antioxidants (selenium, fiber, beta-carotene, vitamin D, vitamin C, vitamin E, folate), a low intake of prooxidants (iron, SFAs, and PUFAS), adequate physical activity, never smoking, and a healthy weight could be a promising strategy toward breast cancer prevention. Therefore, from our point of view, multicomponent interventions should be promoted, and the application of OBSs to study the complexity of the oxidative balance in epidemiological studies by unidimensional measurement. An inverse association was found between a higher antioxidant score and a lower risk of prostate cancer and colorectal adenoma. It is noteworthy that in most of the studies on OBS and its association with disease risk, the main issue is the application of a tool that globally estimates the oxidative balance (41), being less relevant the specific inclusion of certain components or the selected scoring system, as has been observed in studies (23, 38).
Immigrant assimilation and profiles of breast cancer screening behaviors among U.S. immigrant women
Published in Health Care for Women International, 2021
Federico Ghirimoldi, Gabriela Sanchez-Soto
The relevance of breast cancer prevention extends beyond the U.S. Worldwide, breast cancer is the most diagnosed cancer and the principal cause of cancer deaths among adult women (Bray et al., 2004; DeSantis et al., 2015; Shulman et al., 2010). Researchers making global projections show that, assuming that current incidence trends will prevail, around 2.7 million new breast cancer cases will occur by 2030, and 60% of these cases will be happening in less developed countries (Ferlay et al., 2010). Nowadays, the need for global cancer prevention strategies is considerable, but the lack of health care infrastructure and adequate cancer treatment facilities impedes the establishment of long-term prevention policies in less developed countries (Cazap et al., 2016; DeSantis et al., 2015; Tfayli et al., 2010; Vineis & Wild, 2014).
Assessment and management of B3 breast lesions with atypia: a focused review
Published in Climacteric, 2020
M. U. Ugurlu, T. Yoldemir, B. M. Gulluoglu
The preventive effects of an aromatase inhibitor have been studied in high-risk women without breast cancer in the Mammary Prevention.3 trial, where exemestane was compared with placebo in postmenopausal women. Exemestane significantly reduced the incidence of all breast cancer by 53% and invasive breast cancer by 65% after a median follow-up of 3 years66. It was suggested that aromatase inhibitors are the most effective agents available for breast cancer prevention67. The follow-up in the International Breast Cancer Intervention Study II trial was longer than that in the Mammary Prevention.3 trial and adjuvant trials66. In the International Breast Cancer Intervention Study II trial, it was found that most side effects associated with estrogen deprivation were not attributable to the treatment and yet most were also increased in the placebo group. Because anastrozole and exemestane have greater efficacies than do tamoxifen and raloxifene, and have a different but generally decreased detrimental side-effect profile such as endometrium cancer and venous thrombosis, anastrozole or exemestane may emerge as the treatments of choice for risk reduction in most postmenopausal women at high risk of breast cancer despite their intolerability due to joint and bone pain67.