Brisson J, Brisson B, Coté G, Maunsell E, Bérubé S, Robert J
Epidemiology Research Group, Saint-Sacrement Hospital CHA, Quebec City, Quebec, Canada.
Cancer Epidemiol Biomarkers Prev. 2000 Sep;9(9):911-5.
The extent of breast tissue density on mammograms is one of the strongest risk factors for breast cancer. The aim of this analysis was to evaluate whether tamoxifen can affect mammographic breast density. Subjects were participants in the National Surgical Adjuvant Breast Project Breast Cancer Prevention Trial (BCPT), recruited and followed at the Breast Center of Saint-Sacrement Hospital in Quebec City, Canada. The Breast Cancer Prevention Trial is a double-blind trial in which women at high risk of breast cancer were randomized to receive either 20 mg tamoxifen per day or placebo. Mammograms were taken before treatment began and yearly thereafter. For the purpose of this analysis, Wolfe's parenchymal pattern and the percentage of the breast showing tissue densities were assessed by review of pre- and posttreatment mammograms without knowledge of treatment assignment. Among the 69 women included in this analysis, 36 received tamoxifen and 33 received placebo for an average of 3.3 and 3.5 years, respectively. Among women receiving tamoxifen, 16 of 36 (44.4%) changed to a parenchymal pattern of lower density compared with 5 of 33 (15.2%) women receiving placebo (P = 0.010). Moreover, in the tamoxifen-treated group, the difference in the percentage of the breast showing tissue densities between the pre- and posttreatment mammograms reached -9.4% on average compared with a reduction of -3.6% in the placebo group (P = 0.010). Our data show that tamoxifen can reduce high-risk mammographic features. Breast densities should be evaluated as possible early markers of the preventive effect of selective estrogen receptor modulators.
乳房X光片中乳腺组织密度的程度是乳腺癌最强的风险因素之一。本分析的目的是评估他莫昔芬是否会影响乳房X光片上的乳腺密度。研究对象是参与国家外科辅助乳腺项目乳腺癌预防试验（BCPT）的受试者，在加拿大魁北克市圣心医院乳腺中心招募并随访。乳腺癌预防试验是一项双盲试验，将乳腺癌高危女性随机分为两组，分别每日服用20毫克他莫昔芬或安慰剂。在治疗开始前及之后每年进行乳房X光检查。为进行本分析，在不知道治疗分配情况的前提下，通过复查治疗前后的乳房X光片来评估沃尔夫实质模式以及显示组织密度的乳房百分比。本分析纳入的69名女性中，36名接受他莫昔芬治疗，33名接受安慰剂治疗，平均治疗时间分别为3.3年和3.5年。接受他莫昔芬治疗的女性中，36人中有16人（44.4%）转变为密度较低的实质模式，而接受安慰剂治疗的33名女性中有5人（15.2%）出现这种转变（P = 0.010）。此外，在他莫昔芬治疗组中，治疗前后乳房X光片上显示组织密度的乳房百分比平均差异达到-9.4%，而安慰剂组为-3.6%（P = 0.010）。我们的数据表明，他莫昔芬可降低乳房X光片上的高危特征。乳腺密度应作为选择性雌激素受体调节剂预防效果的可能早期标志物进行评估。
