Mammographic changes associated with raloxifene and tibolone therapy in postmenopausal women: a prospective study

Christodoulakos, George; Lambrinoudaki, Ιrene; Vourtsi, A.; Panoulis, Konstantinos; Kelekis, Dimitrios; Creatsas, George

doi:10.1097/00042192-200203000-00005

Cited by 48 publications

(36 citation statements)

References 38 publications

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“…The Study of Tamoxifen and Raloxifene (29) reported that raloxifene is as effective as tamoxifen in reducing the risk of invasive breast cancer in postmenopausal women at increased risk, yet, unlike tamoxifen, raloxifene has not been found to have an effect on mammographic density. Christodoulakos et al reported no statistically significant change in mammographic density in postmenopausal women at risk for osteoporosis or cardiovascular disease after 1 year of raloxifene (n = 48) compared with controls (n = 27) using qualitative measures to score mammographic density (21). Similarly, in a nested pilot study, Freedman et al found that the mean mammographic density in a subgroup of postmenopausal women participating in an osteoporosis prevention trial did not significantly change in women receiving raloxifene compared with placebo.…”

Section: Discussionmentioning

confidence: 99%

“…In the largest cohort (n = 280), Jackson et al determined that no increase in mammographic density occurred in women on raloxifene as opposed to those on combined hormone replacement therapy, whereas in smaller cohorts mammographic density declined from baseline on raloxifene or showed no significant change. The methodology to assess change in mammographic density in these studies included semiquantitative and, in some cases, purely qualitative means to describe mammographic density (20)(21)(22). Although raloxifene has not been shown to have a large effect on mammographic density in these studies, the effect of raloxifene on mammographic density in premenopausal women is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Raloxifene on Mammographic Density and Breast Magnetic Resonance Imaging in Premenopausal Women at Increased Risk for Breast Cancer

Eng‐Wong¹,

Orzano-Birgani²,

Chow³

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Mammographic density is a risk factor for breast cancer. Mammographic density and breast magnetic resonance imaging (MRI) volume (MRIV) assess the amount of fibroglandular tissue in the breast. Mammographic density and MRIV can be modulated with hormonal interventions, suggesting that these imaging modalities may be useful as surrogate endpoint biomarkers for breast cancer chemoprevention trials. We evaluated the effect of raloxifene on mammographic density and MRIV in premenopausal women at increased risk for breast cancer. Methods: Mammograms and MRI were obtained at baseline and after 1 and 2 years of 60 mg raloxifene by mouth daily for 27 premenopausal women. Mammographic percent dense area was calculated using a semiquantitative thresholding technique. T 1 -weighted spoiled gradient-echo MRI with fat suppression was used to determine breast MRIV using a semiautomatic

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of Raloxifene on Mammographic Density and Breast Magnetic Resonance Imaging in Premenopausal Women at Increased Risk for Breast Cancer

Eng‐Wong¹,

Orzano-Birgani²,

Chow³

et al. 2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…12 , 13 Similar to breast cancer risk, a higher percentage of women experience increased mammographic breast density when using EPT than those who use only estrogen therapy (ET). 13 Likewise, women using therapies that reduce breast cancer risk, such as tamoxifen 14 , 15 and raloxifene, 16 -18 experience a decrease in mammographic breast density.…”

mentioning

confidence: 99%

Histologic changes in the breast with menopausal hormone therapy use

Harvey¹,

Santen²,

Petroni

et al. 2008

Menopause

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Objective-This retrospective study systematically compared mammographic density with histology in women receiving or not receiving menopausal hormone therapy (HT).Design-This study was approved by the institutional review board. Twenty-eight postmenopausal women using HT were matched with 28 postmenopausal women not using HT at the time of breast cancer diagnosis. Noncancerous tissue from mastectomy specimens was examined histologically to quantitate the content of fibrous stroma, ducts, and lobule types 1, 2, and 3. Tissue samples were also evaluated for estrogen receptor, progesterone receptor, and Ki67 activity in the ducts and lobules. Breast density was quantified by digitizing the contralateral mammogram and computer-assisted interactive thresholding.Results-High breast density in women using HT was correlated with greater fibrous stroma (P = 0.020) and lobule type 1 (P = 0.016). Breast density also correlated with Ki67 activity in the ducts (P = 0.031) and lobules (P = 0.023) for both groups combined. Estrogen and progesterone receptors did not correlate with either breast density or HT use.Conclusions-Increased fibrous stroma and lobule type 1 are associated with increasing mammographic density in women using HT, independent of estrogen and progesterone receptor up-regulation. These findings suggest that increased breast density may be mediated through a paracrine effect. The increase in breast cancer risk with HT use may be due to an increase in target lobule type 1 cells.

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“…48,49 The sample size ranged from 27 to 444 (n = 2005), and 8 of the 9 studies assessed postmenopausal women. Most of the studies administered 60 mg of RLX per day, and the duration of the RLX administration varied from 3 months to 3 years.…”

Section: Resultsmentioning

confidence: 99%

Relationship Between Breast Density and Selective Estrogen-Receptor Modulators, Aromatase Inhibitors, Physical Activity, and Diet

et al. 2016

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Background. Lower breast density (BD) is associated with lower risk of breast cancer and may serve as a biomarker for the efficacy of chemopreventive strategies. This review explores parameters that are thought to be associated with lower BD. We conducted a systematic review of articles published to date using the PRISMA strategy. Articles that assessed change in BD with estrogen-receptor modulators (tamoxifene [TAM], raloxifene [RLX], and tibolone) and aromatase inhibitors (AIs), as well as cross-sectional and longitudinal studies (LSs) that assessed association between BD and physical activity (PA) or diet were reviewed. Results. Ten studies assessed change in BD with TAM; all reported TAM-mediated BD decreases. Change in BD with RLX was assessed by 11 studies; 3 reported a reduction in BD. Effect of tibolone was assessed by 5 RCTs; only 1 reported change in BD. AI-mediated BD reduction was reported by 3 out of 10 studies. The association between PA and BD was assessed by 21 studies; 4 reported an inverse association. The relationship between diet and BD was assessed in 34 studies. All studies on calcium and vitamin D as well as vegetable intake reported an inverse association with BD in premenopausal women. Two RCTs demonstrated BD reduction with a low-fat, high-carbohydrate intervention. Conclusion. TAM induces BD reduction; however, the effect of RLX, tibolone, and AIs on BD is unclear. Although data on association between diet and BD in adulthood are contradictory, intake of vegetables, vitamin D, and calcium appear to be associated with lower BD in premenopausal women.

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Mammographic changes associated with raloxifene and tibolone therapy in postmenopausal women: a prospective study

Cited by 48 publications

References 38 publications

Effect of Raloxifene on Mammographic Density and Breast Magnetic Resonance Imaging in Premenopausal Women at Increased Risk for Breast Cancer

Effect of Raloxifene on Mammographic Density and Breast Magnetic Resonance Imaging in Premenopausal Women at Increased Risk for Breast Cancer

Histologic changes in the breast with menopausal hormone therapy use

Relationship Between Breast Density and Selective Estrogen-Receptor Modulators, Aromatase Inhibitors, Physical Activity, and Diet

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