Drugs for the gynecologist to prescribe in the prevention of breast cancer: Current status and future trends

Authors
Citation
Sr. Goldstein, Drugs for the gynecologist to prescribe in the prevention of breast cancer: Current status and future trends, AM J OBST G, 182(5), 2000, pp. 1121-1126
Citations number
25
Categorie Soggetti
Reproductive Medicine","da verificare
Journal title
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
ISSN journal
00029378 → ACNP
Volume
182
Issue
5
Year of publication
2000
Pages
1121 - 1126
Database
ISI
SICI code
0002-9378(200005)182:5<1121:DFTGTP>2.0.ZU;2-U
Abstract
Tamoxifen was approved for breast cancer prevention in October 1998. Thus, for the first time, we as gynecologists are being asked to prescribe this d rug to healthy women. In the past each one of us has cared for women with b reast cancer who have been treated with tamoxifen by oncologists or breast surgeons for the malignancy. Effects of tamoxifen on the uterus resulting i n carcinomas, hyperplasia, and polyps are well known, Furthermore, tamoxife n has estrogenic properties in the venous system, increasing the incidence of deep vein thrombosis and pulmonary emboli. A new SERM (selective estroge n receptor modulator), raloxifene, has been approved for prevention and tre atment of osteoporosis in postmenopausal women. It does not have stimulator y effects on the endometrium; however, it is estrogenic in the venous syste m. Preclinical data, as well as the breast cancer incidence reported in stu dies of the skeleton, seem to indicate that its effects in the breast are s imilar to those of tamoxifen. This article reviews tamoxifen and the new SE RM, raloxifene, in an attempt to help gynecologists better understand each compound and what data are currently known, what we hope to learn from futu re studies, and what currently makes sense for clinical practice.