[Hormonotherapy for breast cancer prevention: What about women with genetic predisposition to breast cancer?]

Bull Cancer. 2016 Mar;103(3):273-81. doi: 10.1016/j.bulcan.2016.01.001. Epub 2016 Feb 3.
[Article in French]

Abstract

In France, women carrying BRCA1/2 mutation, at an identified high risk of breast cancer are recommended to undergo breast MRI screening. That screening does not however prevent the risk of developing a breast cancer. The only alternative to breast cancer screening available in France is surgical prevention by prophylactic mastectomy. An interesting option for women who wish to reduce their breast cancer risk, but are unready for prophylactic mastectomy is a preventive hormonal treatment by aromatase inhibitors, or selective estrogens receptor modulators (SERMs). Reliable clinical trials show the efficiency of tamoxifen, raloxifen, exemestane, and anastrozole especially, in reducing breast cancer incidence by 33%, 34%, 65% and 53% respectively. This article tries to sum up the main published trials of breast cancer prevention with hormonal treatment, and presents the latest American and English clinical guidelines concerning hormonal prevention for women at high risk of breast cancer, and starts thinking about the possibilities of hormonoprevention, especially among women carrying a BRCA1/2 mutation in France.

Keywords: BRCA; Breast cancer prevention; Chemoprevention; Chimioprévention; Exemestane; High risk breast cancer; Hormonoprophylaxie; Hormonoprévention; Raloxifen; Raloxifène; Tamoxifen; Tamoxifène.

Publication types

  • Review

MeSH terms

  • Anastrozole
  • Androstadienes / adverse effects
  • Androstadienes / therapeutic use
  • Aromatase Inhibitors / adverse effects
  • Aromatase Inhibitors / therapeutic use
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / prevention & control*
  • Endometrial Neoplasms / chemically induced
  • Female
  • Genes, BRCA1*
  • Genes, BRCA2*
  • Genetic Predisposition to Disease
  • Humans
  • Mastectomy
  • Mutation*
  • Nitriles / adverse effects
  • Nitriles / therapeutic use
  • Prophylactic Surgical Procedures
  • Raloxifene Hydrochloride / adverse effects
  • Raloxifene Hydrochloride / therapeutic use
  • Tamoxifen / adverse effects
  • Tamoxifen / therapeutic use
  • Triazoles / adverse effects
  • Triazoles / therapeutic use

Substances

  • Androstadienes
  • Aromatase Inhibitors
  • Nitriles
  • Triazoles
  • Tamoxifen
  • Anastrozole
  • Raloxifene Hydrochloride
  • exemestane