Prevention – Does It Have a Role in Breast Cancer Treatment?

by Pari Forood, Executive Director, Miles of Hope

Published in The Poughkeepsie Journal, 2011

Poughkeepsie Journal

Studies have shown that the better your physical condition, the less likely you are to succumb to heart disease and certain types of cancer including breast cancer. At the Miles of Hope Breast Cancer Foundation, we make it our business to encourage women to get on the court, field, track and in the lake by sponsoring tournaments for all abilities and all ages. Hoops for Hope Women’s Basketball Tournament, Family Fun Run, Miles of Hope Triathlon, Goals for Hope Women’s Soccer Tournament and the Community Walk for Breast Cancer challenge women whether competitive by nature or by necessity to get into shape and embrace a healthy active lifestyle.

However if there is breast cancer in your family, or if you are deemed high risk for the disease by any number of markers, is there something you can do proactively to prevent it?

Women who are at high risk for breast cancer that is fueled by the hormone estrogen could reduce their risk of getting cancer by taking the hormone-blocking drug Aromasin, according to a study presented at a conference in Chicago in June of this year.

Women are considered to be at high risk for breast cancer if they are older than 60, postmenopausal and/or have had abnormal breast biopsies in which there are some lesions.

“We proved that exemestane (Aromasin) reduced the risk of invasive breast cancer by 65%,” said lead author Dr. Paul Goss, who is a breast cancer specialist at Boston’s Massachusetts General Hospital. Goss presented his research at the annual conference of the American Society of Clinical Oncology. The study has also been published in the New England Journal of Medicine.

According to Dr. Julia Schaefer-Cutillo, oncologist at the Dyson Cancer Center, and a Miles of Hope Board member, Aromasin is one of three drugs in the class of drugs called aromatase inhibitors, which block the production of estrogen in postmenopausal women.

“Two other estrogen-blocking drugs exist,” she explained, “but few women use them to prevent breast cancer because there are rare but serious possible side effects, such as an increased risk of uterine cancer and blood clots.”

Previous studies showed that the cancer drug tamoxifen reduced the risk of getting breast cancer in older women by 50% and the osteoporosis drug raloxifene reduced the risk by 38% after five years of taking the drugs.

Exemestane, better known under the brand name Aromasin, was found to have fewer side effects than tamoxifen, according to Goss. His study enrolled 4,560 healthy postmenopausal women at high risk for breast cancer in a placebo-controlled, double-blinded clinical trial. The 65% risk reduction was found after women had been taking the drugs for only three years.

“This is the first study to show that a new class of drugs called aromatase inhibitors has the ability to prevent breast cancer in high-risk women,” said Dr. Jennifer Litton, who is a breast cancer specialist at the MD Anderson Cancer Center in Houston and is not connected to the research.

Litton says she prescribes tamoxifen in her practice and believes it’s a very good and very affordable drug. But when she tells women about the possible side effects like uterine cancer, “it definitely scares women away, even though the incidence of these side effects is really rare.” She hopes more women in the high-risk category will now be open to taking a cancer-preventing drug like Aromasin.

Dr. Schaefer-Cutillo who works with cancer patients on their chemotherapy says that prevention is the next big news in cancer care. “The new research currently being conducted around the world is focusing on preventing cancer, shrinking tumors with specific drug protocols, and creating particular therapies for each individual patient. We are making great strides in this area and I am thrilled to be able to offer it to my patients.”