Skip to main content
SpringerLink
Log in
Book cover

Breast Cancer pp 87–94Cite as

Chemoprevention

  • Chapter
  • First Online:

  • 125k Accesses

Abstract

Over the past three decades, great efforts have been made to seek cancer chemoprevention strategies. Although the precise mechanisms promoting breast cancer are not completely established, thanks to increasing knowledge of the long process from normal to cancer cell, we can intervene with lifestyle, natural compounds, or drugs so that such process can be blocked or reversed. Moreover, the success of several recent clinical trials in the preventive setting in selected high-risk populations suggests that chemoprevention is an effective strategy. Breast cancer chemoprevention has heavily focused on endocrine intervention, although the drugs active in the prevention of endocrine responsive lesions have no effect in reducing the risk of estrogen-negative breast cancer. Thus, new pathways, biomarkers, and agents are actively searched in this subgroup of cancers and have been recently put under investigation. Finally, we should consider the current limited uptake of breast cancer chemoprevention and understand the different reasons to find appropriate solutions.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Sporn MB (1976) Approaches to prevention of epithelial cancer during the preneoplastic period. Cancer Res 36:2699–2702

    CAS  PubMed  Google Scholar 

  2. O’Shaughnessy AJ, Kelloff GJ, Gordon GB et al (2002) Treatment and prevention of intraepithelial neoplasia: an important target for accelerated new agent development. Clin Cancer Res 8:314–346

    PubMed  Google Scholar 

  3. Meyskens FL Jr, Curt GA, Brenner DE et al (2011) Regulatory approval of cancer risk-reducing (chemopreventive) drugs: moving what we have learned into the clinic. Cancer Prev Res (Phila) 4:311–323

    Article  Google Scholar 

  4. Cummings SR, Tice JA, Bauer S et al (2009) Prevention of breast cancer in postmenopausal women: approaches to estimating and reducing risk. J Natl Cancer Inst 101:384–398

    Article  PubMed  PubMed Central  Google Scholar 

  5. Mavaddat N, Pharoah PD, Michailidou K et al (2015) Prediction of breast cancer risk based on profiling with common genetic variants. J Natl Cancer Inst 107(5):djv036

    Article  PubMed  PubMed Central  Google Scholar 

  6. Althuis MD, Fergenbaum JH, Garcia-Closas M et al (2004) Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol Biomark Prev 13:1558–1568

    CAS  Google Scholar 

  7. Cuzick J, DeCensi A, Arun B et al (2011) Preventive therapy for breast cancer: a consensus statement. Lancet Oncol 12:496–503

    Article  CAS  PubMed  Google Scholar 

  8. Powles TJ, Ashley S, Tidy A et al (2007) Twenty-year follow-up of the Royal Marsden randomized, double-blinded tamoxifen breast cancer prevention trial. J Natl Cancer Inst 99:283–290

    Article  CAS  PubMed  Google Scholar 

  9. Fisher B, Costantino JP, Wickerham DL et al (2005) Tamoxifen for the prevention of breast cancer: current status of the National Surgical Adjuvant Breast and bowel project P-1 study. J Natl Cancer Inst 97:1652–1662

    Article  CAS  PubMed  Google Scholar 

  10. Veronesi U, Maisonneuve P, Rotmensz N et al (2007) Tamoxifen for the prevention of breast cancer: late results of the Italian randomized tamoxifen prevention trial among women with hysterectomy. J Natl Cancer Inst 99:727–737

    Article  CAS  PubMed  Google Scholar 

  11. Cuzick J, Forbes JF, Sestak I et al (2007) Long-term results of tamoxifen prophylaxis for breast cancer—96-month follow-up of the randomized IBIS-I trial. J Natl Cancer Inst 99:272–282

    Article  CAS  PubMed  Google Scholar 

  12. Cuzick J, Powles T, Veronesi U et al (2003) Overview of the main outcomes in breast-cancer prevention trials. Lancet 361:296–300

    Article  CAS  PubMed  Google Scholar 

  13. Wickerham DL et al (2015) Final updated results of the NRG oncology/NSABP protocol P-2: study of tamoxifen and raloxifene (STAR) in preventing breast cancer. ASCO annual meeting. J Clin Oncol 33(suppl; abstr 1500):1500

    Google Scholar 

  14. Cuzick J, Sestak I, Bonanni B (2013) Selective oestrogen receptor modulators in prevention of breast cancer: an updated meta-analysis of individual participant data. Lancet 381:1827–1834

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Decensi A, Bonanni B, Guerrieri-Gonzaga A et al (1998) Biologic activity of tamoxifen at low doses in healthy women. J Natl Cancer Inst 90:1461–1467

    Article  CAS  PubMed  Google Scholar 

  16. Decensi A, Robertson C, Guerrieri-Gonzaga A et al (2009) Randomized double-blind 2 × 2 trial of low-dose tamoxifen and fenretinide for breast cancer prevention in high-risk premenopausal women. J Clin Oncol 27:3749–3756

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Guerrieri-Gonzaga A, Lazzeroni M, Botteri E et al (2013) Effect of low-dose tamoxifen after surgical excision of ductal intraepithelial neoplasia: results of a large retrospective monoinstitutional cohort study. Ann Oncol 24:1859–1866

    Article  CAS  PubMed  Google Scholar 

  18. Decensi A, Bonanni B, Maisonneuve P et al (2013) A phase-III prevention trial of low-dose tamoxifen in postmenopausal hormone replacement therapy users: the HOT study. Ann Oncol 24:2753–2760

    Article  CAS  PubMed  Google Scholar 

  19. Cuzick J (2005) Aromatase inhibitors for breast cancer prevention. J Clin Oncol 23:1636–1643

    Article  CAS  PubMed  Google Scholar 

  20. Dowsett M, Cuzick J, Ingle J et al (2010) Meta-analysis of breast cancer outcomes in adjuvant trials of aromatase inhibitors versus tamoxifen. J Clin Oncol 28:509–518

    Article  CAS  PubMed  Google Scholar 

  21. Goss PE, Ingle JN, Alés-Martínez JE et al (2011) Exemestane for breast-cancer prevention in postmenopausal women. N Engl J Med 364:2381–2391

    Article  CAS  PubMed  Google Scholar 

  22. Cuzick J, Sestak I, Forbes JF et al (2014) Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial. Lancet 383:1041–1048

    Article  CAS  PubMed  Google Scholar 

  23. The Arimidex, Tamoxifen, Alone or in Combination (ATAC) Trialists’ Group (2006) Comprehensive side-effect profile of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: long-term safety analysis of the ATAC trial. Lancet Oncol 7:633–643

    Article  Google Scholar 

  24. Coombes RC, Kilburn LS, Snowdon CF et al (2007) Survival and safety of exemestane versus tamoxifen after 2–3 years’ tamoxifen treatment (intergroup exemestane study): a randomised controlled trial. Lancet 369:559–570

    Article  CAS  PubMed  Google Scholar 

  25. Carey LA, Perou CM, Livasy CA et al (2006) Race, breast cancer subtypes, and survival in the Carolina breast cancer study. JAMA 295:2492–2502

    Article  CAS  PubMed  Google Scholar 

  26. Foulkes WD, Smith IE, Reis-Filho JS (2010) Triple-negative breast cancer. N Engl J Med 363:1938–1948

    Article  CAS  PubMed  Google Scholar 

  27. Garattini E, Bolis M, Garattini SK et al (2014) Retinoids and breast cancer: from basic studies to the clinic and back again. Cancer Treat Rev 40:739–749

    Article  CAS  PubMed  Google Scholar 

  28. Veronesi U, Mariani L, Decensi A et al (2006) Fifteen-year results of a randomized phase III trial of fenretinide to prevent second breast cancer. Ann Oncol 17(1065):1071

    Google Scholar 

  29. Gandini S, Puntoni M, Heckman-Stoddard BM et al (2014) Metformin and cancer risk and mortality: a systematic review and meta-analysis taking into account biases and confounders. Cancer Prev Res (Phila) 7:867–885

    Article  CAS  Google Scholar 

  30. DeCensi A, Puntoni M, Goodwin P et al (2010) Metformin and cancer risk in diabetic patients: a systematic review and meta-analysis. Cancer Prev Res (Phila) 3:1451–1461

    Article  CAS  Google Scholar 

  31. Sahra IB, Laurent K, Loubat A et al (2008) The antidiabetic drug metformin exerts an antitumoral effect in vitro and in vivo through a decrease of cyclin D1 level. Oncogene 27:3576–3586

    Article  PubMed  Google Scholar 

  32. Bonanni B, Puntoni M, Cazzaniga M et al (2012) Dual effect of metformin on breast cancer proliferation in a randomized presurgical trial. J Clin Oncol 30:2593–2600

    Article  CAS  PubMed  Google Scholar 

  33. Hadad IT, Jordan L et al (2011) Evidence for biological effects of metformin in operable breast cancer: a pre-operative, window-of-opportunity, randomized trial. Breast Cancer Res Treat 128:783–794

    Article  CAS  PubMed  Google Scholar 

  34. Niraula S, Dowling RJ, Ennis M et al (2012) Metformin in early breast cancer: a prospective window of opportunity neoadjuvant study. Breast Cancer Res Treat 135:821–830

    Article  CAS  PubMed  Google Scholar 

  35. Cazzaniga M, DeCensi A, Pruneri G et al (2013) The effect of metformin on apoptosis in a breast cancer presurgical trial. Br J Cancer 109:2792–2797

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. A phase III randomized trial of metformin versus placebo on recurrence and survival in early stage breast cancer. http://clinicaltrials.gov/show/NCT01101438

  37. Phase II randomized study of neoadjuvant metformin plus letrozole vs placebo plus letrozole for er-positive postmenopausal breast cancer. http://clinicaltrials.gov/ct2/show/NCT01589367?term=han+metformin+breast&rank=1

  38. Phase II pre-surgical intervention study for evaluating the effect of metformin on breast cancer proliferation. http://clinicaltrials.gov/ct2/show/NCT00930579?term=hershman+metformin+breast&rank=1

  39. Metformin hydrochloride in patients with atypical hyperplasia or in situ breast cancer to placebo in decreasing atypical cells in patients with atypical hyperplasia or in situ breast cancer. http://clinicaltrials.gov/ct2/show/record/NCT01905046?term=phase+III+metformin+breast&rank=2

  40. Choi YK, Park KG (2013) Metabolic roles of AMPK and metformin in cancer cells. Mol Cells 36:279–287

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Phoenix KN, Vumbaca F, Claffey KP (2009) Therapeutic metformin/AMPK activation promotes the angiogenic phenotype in the ERalpha negative MDA-MB-435 breast cancer model. Breast Cancer Res Treat 113:101–111

    Article  CAS  PubMed  Google Scholar 

  42. Hadji P, Coleman RE, Wilson C (2016) Adjuvant bisphosphonates in early breast cancer: consensus guidance for clinical practice from a European panel. Ann Oncol 27:379–390

    Article  CAS  PubMed  Google Scholar 

  43. Hall TJ, Schaueblin M (1994) A pharmacological assessment of the mammalian osteoclast vacuolar H + −ATPase. Bone Miner 27:159–166

    Article  CAS  PubMed  Google Scholar 

  44. Rennert G, Pinchev M, Rennert HS (2010) Use of bisphosphonates and risk of postmenopausal breast cancer. J Clin Oncol 28:3577–3581

    Article  CAS  PubMed  Google Scholar 

  45. Chleboski RT, Chen Z, Cauley JA et al (2010) Oral bisphosphonate use and breast cancer incidence in postmenopausal women. J Clin Oncol 28:3582–3590

    Article  Google Scholar 

  46. Lu C, Speers C, Zhang Y et al (2003) 2003 effect of epidermalgrowth factor receptor inhibitor on development of estrogen receptor-negative mammary tumors. J Natl Cancer Inst 95:1825–1833

    Article  CAS  PubMed  Google Scholar 

  47. Hartmnn JT, Haap M, Kopp HG et al (2009) Tyrosine kinase inhibitors—a review on pharmacology, metabolism and side effects. Curr Drug Metab 10:470–481

    Article  Google Scholar 

  48. Cameron D, Casey M, Press M et al (2008) A phase III randomized comparison of lapatinib plus capecitabine versus capecitabine alone in women with advanced breast cancer that has progressed on trastuzumab: updated efficacy and biomarker analyses. Breast Cancer Res Treat 112:533–543

    Article  CAS  PubMed  Google Scholar 

  49. Lin NU, Carey LA, Liu MC et al (2008) Phase II trial of lapatinib for brain metastases in patients with human epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol 26:1993–1999

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Strecke TE, Shen Q, Y Z et al (2009) Effect of lapatinib on the development of estrogen receptor-negative mammary tumors in mice. J Natl Cancer Inst 101:107–113

    Article  Google Scholar 

  51. Chan A, Delaloge S, Holmes FA (2016) Neratinib after trastuzumab-based adjuvant therapy in patients with HER2-positive breast cancer (ExteNET): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 17:367–377

    Article  CAS  PubMed  Google Scholar 

  52. Kushi H, Doyle C, McCullough M et al (2012) American cancer society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 62:30–67

    Article  PubMed  Google Scholar 

  53. Reddy OB, Bhoola KD (2003) Natural products for cancer prevention: a global perspective. Pharmacol Ther 99:1–13

    Article  CAS  PubMed  Google Scholar 

  54. Wald J, Law MR (2003) A strategy to reduce cardiovascular disease by more than 80%. BMJ 326:1419

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Medical Oncology, EO. Ospedali Galliera, 16128, Genoa, Italy

    Andrea De Censi

  2. Division of Cancer Prevention and Genetics, European Institute of Oncology, 20141, Milan, Italy

    Bernardo Bonanni & Massimiliano Cazzaniga

Authors
  1. Andrea De Censi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bernardo Bonanni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Massimiliano Cazzaniga
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrea De Censi .

Editor information

Editors and Affiliations

  1. European Institutee of Oncology, Milan, Italy

    Umberto Veronesi

  2. European Institute of Oncology, Milan, Italy

    Aron Goldhirsch

  3. European Institute of Oncology, Milan, Italy

    Paolo Veronesi

  4. San Raffaele University and Research Hospital, Milano, Italy

    Oreste Davide Gentilini

  5. European Institute of Oncology, Milan, Italy

    Maria Cristina Leonardi

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

De Censi, A., Bonanni, B., Cazzaniga, M. (2017). Chemoprevention. In: Veronesi, U., Goldhirsch, A., Veronesi, P., Gentilini, O., Leonardi, M. (eds) Breast Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-48848-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-48848-6_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-48846-2

  • Online ISBN: 978-3-319-48848-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation