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Breast Cancer

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In 1977, tamoxifen, a nonsteroidal antiestrogen, was approved in the United States for the management of advanced breast cancer in postmenopausal women. Since that time, tamoxifen's therapeutic role has grown to

Tamoxifen is currently the endocrine treatment of choice for all stages of breast cancer and is the gold standard for antiestrogen treatment. Over the last 25 years, the drug has revolutionized breast cancer therapy. The extension of the use of this agent has occurred because of open dialogue between the laboratory and the clinic, in which laboratory findings led to extension of clinical use. Tamoxifen was originally discovered as part of a contraceptive research program at ICI Pharmaceuticals (now Zeneca). On the basis of the estrogen dependence of many breast cancers, tamoxifen, a potent antiestrogen, was predicted to have anticancer activity. Laboratory and animal studies demonstrated efficacy in breast cancer and an ability to block binding of estradiol to the estrogen receptor of human breast cancer. Preclinical studies showed the benefit of long-term vs short-term tamoxifen treatment, a finding duplicated in the clinic. [ONCOLOGY 11(Suppl 1):7-13, 1997]

DALLAS-A new interactive computer program, The Ethics Companion, is currently under development to help physicians think through ethical dilemmas in genetic testing for breast cancer, Gail Tomlinson, MD, PhD, of the University of Texas Southwestern Medical Center, said at a poster paper at the San Antonio meeting.

BOSTON-Neither the presence nor the extent of lobular carcinoma in situ (LCIS) is related to risk of local recurrence in patients with invasive breast cancer treated with conservative surgery and radiotherapy, a retrospective study from the Joint Center for Radiation Therapy has shown.

SAN ANTONIO--A new decision aid, developed by a group of Canadian researchers, uses an audiotape and a workbook to help women with early-stage breast cancer decide between mas-tectomy and breast-conserving surgery with radiation therapy.

CHICAGO--Although mammography is the best screening tool for breast cancer, it misses carcinoma in 15% or more of women with dense breasts. Supplemental, bilateral, high-resolution ultrasound can find these malignancies, Thomas M. Kolb, MD, a New York City radiologist who specializes in breast cancer detection, reported at the Radiological Society of North America meeting.

ROCKVILLE, Md--The Food and Drug Administration's Oncologic Drugs Advisory Committee (ODAC) voted, with one abstention, to recommend the approval of Femara Tablets (letrozole, Ciba-Geigy Corp.) for the treatment of advanced breast cancer in postmenopausal women who suffer a relapse or disease progression after antiestrogen therapy.

COLUMBUS, Ohio--Many of the diagnostic tests and procedures following treatment for breast cancer fail to extend survival, as demonstrated by two randomized, prospective studies and nine retrospective studies, said Victor G. Vogel, MD, MHS, director of the Comprehensive Breast Cancer Program at the University of Pittsburgh.

PALM SPRINGS, Calif--A large body of research on toremifene (Fareston) has been accumulated in research carried out over more than a decade in Europe, the United States, and the former Soviet Union, John T. Hamm, MD, of the University of Louisville and Alliant Health Systems, said in his presentation on the phase II trials of the agent.

SAN ANTONIO--Hormone responsiveness is one of the few prognostic markers for breast cancer that actually predicts a better prognosis, Benita S. Katzenellenbogen, PhD, said in her William L. McGuire Memorial Lecture at the San Antonio Breast Cancer Symposium.

BETHESDA, Md--The American Medical Writers Association is accepting applications for the 1997 Rose Kushner Awards for Writing Achievement in the Field of Breast Cancer. A cash award of $1,000 for the winning entry in each of five categories will be provided through a grant from Zeneca Pharmaceuticals.

CHICAGO--Scintimammogra-phy, a nuclear medicine procedure developed in the early 1990s, has potential as a diagnostic tool for identifying breast cancer in women whose disease hides within dense tissue, said Janet Baum, MD, a radiologist at New England Deaconess Hospital, Boston

An expert panel of 10 international cancer researchers and practicing oncologists met in Boston to discuss the past, present, and future uses of antiestrogens in the treatment of breast cancer. The first articles in this series, based on the symposium presentations, focused on the optimal duration of tamoxifen use (Oct, 1996, page 17) and on the noncancer benefits of tamoxifen weighed against the potential risk of endometrial cancer (Nov, 1996, page 55). This month, the benign endometrial changes associated with tamoxifen use are reviewed. The symposium was sponsored by Zeneca Pharmaceuticals.