Dr. Tripathy Discusses Breast Cancer Prevention

Debu Tripathy, MD, co-leader of the Women’s Cancer Program at the Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, discusses the use of pharmaceuticals to prevent the occurrence of contralateral breast cancer.

Tripathy explains that it has been known for some time that tamoxifen and aromatase inhibitors can lower the risk of developing a new contralateral tumor. The efficacy of these agents has been further supported in newer trials showing an approximate 50% reduction in new tumors.

More recently the focus has shifted towards the agent raloxifene, which seems to cause fewer side effects, such as endometrial cancer and deep venous thrombosis.

The side effect profile remains a concern because the available risk stratification tools make it difficult to predict which patients will contrive the highest benefit. The tools are reasonably accurate on a broad population level, but lose their efficacy on an individual basis. The inability to predict responses has led to the infrequent use of preventive agents.

More research is needed to help predict the patients that will benefit the most and to reduce the side effects associated with the treatments.

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