1. Selective oestrogen receptor modulators in prevention of breast cancer: an updated meta-analysis of individual participant data
- Author
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Cuzick, Jack, Sestak, Ivana, Bonanni, Bernardo, Costantino, Joseph P, Cummings, Steve, DeCensi, Andrea, Dowsett, Mitch, Forbes, John F, Ford, Leslie, LaCroix, Andrea Z, Mershon, John, Mitlak, Bruce H, Powles, Trevor, Veronesi, Umberto, Vogel, Victor, Wickerham, D Lawrence, and SERM Chemoprevention of Breast Cancer Overview Group
- Subjects
Selective Estrogen Receptor Modulators ,Aging ,Prevention ,Evaluation of treatments and therapeutic interventions ,Breast Neoplasms ,Kaplan-Meier Estimate ,Medical and Health Sciences ,Postmenopause ,Treatment Outcome ,Risk Factors ,6.1 Pharmaceuticals ,General & Internal Medicine ,Breast Cancer ,Humans ,Anticarcinogenic Agents ,Female ,SERM Chemoprevention of Breast Cancer Overview Group ,Randomized Controlled Trials as Topic ,Cancer - Abstract
BackgroundTamoxifen and raloxifene reduce the risk of breast cancer in women at elevated risk of disease, but the duration of the effect is unknown. We assessed the effectiveness of selective oestrogen receptor modulators (SERMs) on breast cancer incidence.MethodsWe did a meta-analysis with individual participant data from nine prevention trials comparing four selective oestrogen receptor modulators (SERMs; tamoxifen, raloxifene, arzoxifene, and lasofoxifene) with placebo, or in one study with tamoxifen. Our primary endpoint was incidence of all breast cancer (including ductal carcinoma in situ) during a 10 year follow-up period. Analysis was by intention to treat.ResultsWe analysed data for 83,399 women with 306,617 women-years of follow-up. Median follow-up was 65 months (IQR 54-93). Overall, we noted a 38% reduction (hazard ratio [HR] 0·62, 95% CI 0·56-0·69) in breast cancer incidence, and 42 women would need to be treated to prevent one breast cancer event in the first 10 years of follow-up. The reduction was larger in the first 5 years of follow-up than in years 5-10 (42%, HR 0·58, 0·51-0·66; p
- Published
- 2013