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Breast Cancer Prevention: Tamoxifen vs. Raloxifene

Posted Apr 21 2010 6:29am
The ultimate goal in breast cancer research (or any disease research) is to find a way to prevent breast cancer from occurring.  Tamoxifen is widely used to treat breast cancer patients with estrogen receptor - positive breast cancer; however, it has also been approved since 1998 to help prevent breast cancer in high risk breast cancer patients.  This approval was based on the Breast Cancer Prevention Trial , which showed that high risk breast cancer patients who took tamoxifen for 5 years showed a 50% reduction in breast cancer risk.

Over the last several years, a breast cancer research clinical trial called Study of Tamoxifen and Raloxifene (STAR) has been running to compare the effectiveness of raloxifene to tamoxifen for reducing breast cancer risk.  The updated results from this trial were presented on Monday at the 101st Annual Meeting of the American Association for Cancer Research .  Some of the results presented showed that
  • After 81 months of follow-up, raloxifene was shown to be 76% as effective as tamoxifen at reducing the risk for invasive breast cancer in women at high risk for breast cancer.
  • For non-invasive breast cancers, raloxifene was about 78% as effective as tamoxifen.
  • Raloxifene had a substantially safer profile with a 45% reduction in endometrial cancer and and 25% reduction in risk for serious blood clots compared to women taking tamoxifen.
Based on these results it appears that while raloxifene clearly reduces the risk for developing breast cancer in high risk women, it is not quite as effective as tamoxifen .  However, raloxifene appears to be a much safer alternative to tamoxifen due to fewer side effects, particularly in regards to rare side effects like endometrial cancer and blood clots.  This is good news for women at high risk for breast cancer who are interested in reducing their breast cancer risk, since the results of this study suggest a safer alternative to tamoxifen.  Despite the fact that these two drugs have been shown to reduce the risk of developing breast cancer, many women are reluctant to take this breast cancer prevention route and many doctors are apparently reluctant to suggest it.  According to an article in the NCI Cancer Bulletin, this is likely because there is no way to know if the patient is improving upon her risk or not.

You can read a more detailed story about this study in the NCI Cancer Bulletin or if you are interested you can actually watch a webcast of the full 17 minute presentation on the meeting website.  To watch the webcast, just click HERE , pick the April 19th date and scroll down to the 10:00 am Special Session by Dr. Wickerham.

In addition to pharmaceutical drugs that can reduce breast cancer risk, there are diet and lifestyle changes we can all make to reduce our risk for breast cancer.  To learn more, read my book Fight Now: Eat & Live Proactively Against Breast Cancer at www.fightBCnow.com .
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