Chemoprevention Of Breast Cancer

There might be a place for chemoprevention with regard to breast cancer. In a group of women who have a familial constellation for breast cancer of both breasts the anti-estrogen medication tamoxifen was used to reduce the risk of developing breast cancer in the other breast after mastectomy (surgical removal of the one breast). The risk of breast cancer in the other breast was reduced to 40% of the expected risk with this medication.

However, there are significant tamoxifen side effects and the use of it is usually limited to high-risk settings. The idea of cancer prevention utilizing hormone modulating medications is not new. In males there is an equivalent prostate cancer prevention medication, finasteride, which is medication that is used for treatment of an enlarged prostate gland. It turns out that in males this also has a significant prostate cancer prevention effect and is even effective at reduced doses that are used for male baldness treatment with finasteride. This makes it more likely that in women there would also be a useful place in certain instances for chemoprevention of breast cancer. A new observation is that women on balanced hormone replacement with bio-identical estrogen and progesterone hormones enjoy longer lives with no development of breast, uterine, colon and other cancers. This fact has been published in the anti-aging literature between 2000 and 2008. Dr. Lee points out that with saliva hormone tests, which is the only reliable test that reflects the tissue levels of hormones, estrogen levels can be kept at a ratio of 1:200 (level of progesterone 200-fold higher or more than the estrogen level). This will keep estrogen under control and prevent the development of breast cancer or uterine cancer (Ref. 9 and 10).

Other agents of interest are retinoids (=vitamin A derivatives), which have been very effective in animal experiments and are being investigated for effectiveness in humans. The aromatase inhibitor, astrozole (brand name: Arimidex), prevents the conversion of androgens from the adrenal glands being converted into estrogen substances.

This will reduce the risk for breast cancer for those cancers that have positive estrogen receptors even further. Your doctor or oncologist can advise you what medication applies to your condition.

Here is a link to a government site recommending chemoprevention of breast cancer in certain cases. This type of approach may be particularly warranted in families where there is a genetically higher risk of breast cancer, but not the high risk setting that warrants bilateral removal of the breast tissue. Discuss this with your family doctor.

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

The following references were used apart from my own clinical experience:

1. Cancer: Principles &Practice of Oncology, 4th edition, by V.T. De Vita,Jr.,et. al J.B. LippincottCo.,Philadelphia, 1993.Vol.2: Chapter 48.

2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 177.

3. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter 36: 1541-1616.

4. BS Herbert et al. Breast Cancer Res 2001;3(3):146-149.

5. BS Herbert et al. J Natl Cancer Inst 2001 Jan 3;93(1):39-45.

8. Dr. John R. Lee and Virginia Hopkins: "Hormone Balance Made Simple - The Essential How-to Guide to Symptoms, Dosage, Timing, and More". Wellness Central, NY, 2006

9. Dr. John R. Lee, David Zava and Virginia Hopkins: "What your doctor may not tell you about breast cancer - How hormone balance can help save your life", Wellness Central, Hachette Book Group USA, 2005. Page 29 - 38 (Chapter 2): Risk factors for breast cancer. Page 360 to 374 explains about xenohormones and how they cause estrogen dominance. Pages 221 to 234 (chapter 12) explains why Tamoxifen is not recommended and bio-identical progesterone is more powerful in preventing breast and uterine cancer.

Last Modified: Aug. 23, 2009