Tamoxifen:
Prevention or delay of clinical onset of disease
with
Neil Love, MD from Breast Cancer Update for Surgeons, Program
1 2000
Play
Audio Below:
I
think we have substantial proof that pre-cancerous lesions can be
inhibited or can be held back from developing into cancerous lesions.
And I think of it here as an iceberg, where we know that the tip
of the iceberg showing above the waves is the cancer. Just beneath
that is a larger group of people with what we call "occult breast
cancer." This is DCIS and discoverable by mammography but not by
clinical means. Beneath that is the even larger layer of people
with the ADH and ALH changes that the pathologists can identify
but that the mammographer and the clinician can’t. And so on,
going on down, there are changes that only a cell biologist can
show with disorders of receptors and so on, where there’s over
production. And of course, the lowest layer is the molecular biology
layer where you can show that the genes are incorrect. Well, there
is one more layer and it’s normal people. We don’t know
who they are and how many of them there are. It may be that after
adolescence, changes take place and there are no more normal people,
so to speak, in whatever type definition you want to make. So, if
you’re looking only at the cancers you have one point of view,
but if you’re looking at this as a continuum and that people
are moving up this ladder, or this iceberg, layer by layer at different
rates so that some people will get there faster, people that inherit
a genetic defect will start a layer or so higher than others and
have less distance to go and therefore, other genetic changes will
bring them to the point of cancer sooner. Now you can, at least,
design attacks and try to suppress this and tamoxifen does that.
Impact
of young age on outcome in patients with ductal carcinoma-in-situ
treated with breast-conserving therapy Vicini, F. A.; Kestin, L. L.; Goldstein, N. S.; Chen, P. Y.;
Pettinga, J.; Frazier, R. C., and Martinez, A. A.. Journal of Clinical
Oncology. 18(2):296-306, 2000 Jan.
Carcinoma
in situ of the breast: correlation of histopathology to immunohistochemical
markers and DNA ploidy. Ottesen,
G. L.; Christensen, I. J.; Larsen, J. K.; Larsen, J.; Baldetorp,
B.; Linden, T.; Hansen, B., and Andersen, J. (Reprint available
from: Ottesen GL Univ Copenhagen, Inst Forens Med, Dept Forens Pathol
Frederik Vs Vej 11,POB 2713 DK-2100 Copenhagen O Denmark).. Breast
Cancer Research & Treatment. 60(3):219-226, 2000 Apr In process
Application
of the Van Nuys prognostic index in a retrospective series of 367
ductal carcinomas in situ of the breast examinated by serial macroscopic
sectioning: Practical considerations. de
Mascarel, I.; Bonichon, F.; MacGrogan, G.; de Lara, C. T.; Avril,
A.; Picot, V.; Durand, M.; Mauriac, L.; Trojani, M., and Coindre,
J. M. Breast Cancer Research & Treatment. 61(2):151-159, 2000
May. In process
Postexcision
mammography is indicated after resection of ductal carcinoma-in-situ
of the breast. Waddell, B. E.; Stomper, P. C.; DeFazio, J. L.; Hurd, T. C.,
and Edge, S. B. Annals of Surgical Oncology. 7(9):665-668, 2000
Oct. In process
Ductal
carcinoma in situ of the breast: A surgeon's disease. Silverstein, M. J. (Reprint available from: Silverstein MJ Univ
So Calif, Kenneth Norris Jr Comprehens Canc Ctr 1441 Eastlake Ave,Room
7415 Los Angeles, CA 90033 USA). Annals of Surgical Oncology. 6(8):802-810,
1999 Dec. No abstract
Role
of specimen radiography in patients treated with skin-sparing mastectomy
for ductal carcinoma in situ of the breast. Rubio, I. T.; Mirza, N.; Sahin, A. A.; Whitman, G.; Kroll, S.
S.; Ames, F. C., and Singletary, S. E. Annals of Surgical Oncology.
7(7):544-548, 2000 Aug. In process
Carcinoma
in situ of the female breast. 10 year follow-up results of a prospective
nationwide study. Ottesen, G. L.; Graversen, H. P.; Blichert-Toft, M.; Christensen,
I. J., and Andersen, J. A. (Reprint available from: Ottesen GL Univ
Copenhagen, Inst Forens Med, Dept Forens Pathol Frederik Vs Vej
11,POB 2713 DK-2100 Copenhagen Denmark).. Breast Cancer Research
& Treatment. 62(3):197-210, 2000 Aug In process
Outcomes
and factors impacting local recurrence of ductal carcinoma in situ. Lagios, M. D. and Silverstein, M. J. (Reprint available from:
Lagios MD St Marys Med Ctr, Breast Canc Consultat Serv San Francisco,
CA 94143 USA).. Cancer. 89(11):2323-2324, 2000 Dec 1. In process
Sentinel
lymph node biopsy: Is it indicated in patients with high-risk ductal
carcinoma-in-situ and ductal carcinoma-in-situ with microinvasion? Klauber-DeMore, N.; Tan, L. K.; Liberman, L.; Kaptain, S.; Fey,
J.; Borgen, P.; Heerdt, A.; Montgomery, L.; Paglia, M.; Petrek,
J. A.; Cody, H. S., and Van Zee, K. J. Annals of Surgical Oncology.
7(9):636-642, 2000 Oct. In process
Relation
of a recurrent intraductal carcinoma (ductal carcinoma in situ)
to the primary tumor Fisher, E. R. and Fisher, B. (Reprint available
from: Fisher B NSABP Sci Directors Off 4 Allegheny Ctr,Suite 602
Pittsburgh, PA 15212 USA).. Journal of the National Cancer Institute.
92(4):288-289, 2000 Feb 16. No abstract
