Breast cancer is one of the most common forms of cancer affecting women, with approximately one in seven women in the UK developing the disease.
For post-menopausal women, higher levels of the hormone estrogen in their blood can increase the risk of developing breast cancer. To address this risk, preventive medications known as aromatase inhibitors, like anastrozole, have been recommended.
However, not all women benefit equally from these medications, and understanding who will benefit the most has been a challenge.
In a significant breakthrough, a team of researchers led by Professor Jack Cuzick at Queen Mary University of London has found that hormone levels, measured through simple blood tests, can help identify post-menopausal women who would benefit the most from aromatase inhibitors for breast cancer prevention.
This discovery, published in Lancet Oncology, could lead to more effective and personalized breast cancer prevention strategies.
Aromatase inhibitors, such as anastrozole, are designed to reduce the production of estrogen in the body. Lowering estrogen levels can help reduce the risk of developing estrogen-receptor positive breast cancer, one of the most common types of the disease.
While these medications are effective, not all women experience the same level of benefit, and some may also face side effects.
To better understand how blood hormone levels could be used to personalize breast cancer prevention, the researchers analyzed data from the IBIS-II prevention trial, an international study conducted between 2003 and 2012.
They focused on estrogen levels in the blood and their association with breast cancer risk.
In their analysis, the researchers identified a clear trend: women with higher estrogen levels in the placebo group had an increased risk of developing breast cancer. However, this trend was not observed in the group of women taking anastrozole.
In fact, those taking anastrozole experienced a remarkable 55% reduction in their risk of developing cancer. Importantly, this benefit was most pronounced in women with higher estrogen levels.
What makes this discovery particularly exciting is its potential for personalization. By using a simple and affordable blood test to measure hormone levels, healthcare providers could identify women who are at the greatest risk of breast cancer and are most likely to benefit from preventive therapy with an aromatase inhibitor.
Professor Jack Cuzick emphasized the significance of these findings, saying, “These results are very exciting and can refine how we choose preventive medication for post-menopausal women at high risk of breast cancer.”
The research revealed that women with the lowest estradiol measurements benefitted the least from anastrozole while still experiencing side effects.
Dr. David Crosby, head of prevention and early detection at Cancer Research UK, added, “This research now gives us some clues about which women would benefit most from the drug, while identifying women who won’t benefit and can be spared unnecessary side effects.”
In conclusion, this breakthrough offers a promising path toward more personalized and effective breast cancer prevention.
By identifying women at the highest risk through hormone level testing, healthcare providers can tailor preventive strategies, providing the best balance between managing cancer risk and minimizing side effects.
While there is still more research to be done, these findings bring us closer to a future where breast cancer prevention is not only more effective but also more individualized.
The research findings can be found in The Lancet Oncology
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