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Tamoxifen-Induced Reduction in Mammographic Density and Breast Cancer Risk Reduction: A Nested Case-Control Study
- Source :
- JNCI Journal of the National Cancer Institute. 103:744-752
- Publication Year :
- 2011
- Publisher :
- Oxford University Press (OUP), 2011.
-
Abstract
- Mammographic breast density is a strong risk factor for breast cancer. Tamoxifen, which reduces the risk of breast cancer in women at high risk, also reduces mammographic breast density. However, it is not known if tamoxifen-induced reductions in breast density can be used to identify women who will benefit the most from prophylactic treatment with this drug.We conducted a nested case-control study within the first International Breast Cancer Intervention Study, a randomized prevention trial of tamoxifen vs placebo. Mammographic breast density was assessed visually and expressed as a percentage of the total breast area in 5% increments. Case subjects were 123 women diagnosed with breast cancer at or after their first follow-up mammogram, which took place 12-18 months after trial entry, and control subjects were 942 women without breast cancer. Multivariable logistic regression was used to adjust for other risk factors. All statistical tests were two-sided.In the tamoxifen arm, 46% of women had a 10% or greater reduction in breast density at their 12- to 18-month mammogram. Compared with all women in the placebo group, women in the tamoxifen group who experienced a 10% or greater reduction in breast density had 63% reduction in breast cancer risk (odds ratio = 0.37, 95% confidence interval = 0.20 to 0.69, P = .002), whereas those who took tamoxifen but experienced less than a 10% reduction in breast density had no risk reduction (odds ratio = 1.13, 95% confidence interval = 0.72 to 1.77, P = .60). In the placebo arm, there was no statistically significant difference in breast cancer risk between subjects who experienced less than a 10% reduction in mammographic density and subjects who experienced a greater reduction.The 12- to 18-month change in mammographic breast density is an excellent predictor of response to tamoxifen in the preventive setting.
- Subjects :
- Adult
Oncology
Cancer Research
medicine.medical_specialty
Time Factors
Antineoplastic Agents, Hormonal
Breast Neoplasms
Risk Assessment
Breast cancer
Estrogen Receptor Modulators
Predictive Value of Tests
Risk Factors
Internal medicine
Odds Ratio
medicine
Humans
Breast
Risk factor
skin and connective tissue diseases
Aged
Gynecology
Analysis of Variance
Australasia
business.industry
Reproducibility of Results
Cancer
Confounding Factors, Epidemiologic
Odds ratio
Middle Aged
medicine.disease
Antiestrogen
United Kingdom
Europe
Tamoxifen
Logistic Models
Research Design
Case-Control Studies
Nested case-control study
Female
Breast disease
business
Mammography
medicine.drug
Subjects
Details
- ISSN :
- 14602105 and 00278874
- Volume :
- 103
- Database :
- OpenAIRE
- Journal :
- JNCI Journal of the National Cancer Institute
- Accession number :
- edsair.doi.dedup.....5e44abd7484d0fd6fa79778628159c30