Crowell E B, Jubelirer S J
Mary Babb Randolph Cancer Center, West Virginia University School of Medicine, Morgantown, USA.
W V Med J. 2000 Nov-Dec;96(6):598-601.
Breast cancer is a major health concern for women in the U.S. Several factors determine a woman's risk for developing breast cancer including age, genetics, hormonal exposure and others. It is possible to estimate a woman's risk for developing breast cancer by using a statistical model known as the Gail model. Using this model, the Breast Cancer Prevention Trial (BCPT) found that women at high risk for breast cancer could have their incidence of breast cancer reduced by 49% by taking tamoxifen. The serious side effects of tamoxifen therapy were almost exclusively seen in women over age 50. Women under 50 with a high risk of breast cancer are, therefore, most likely to benefit from taking tamoxifen for five years. Thus, a benefit-to-risk estimate should be made for each woman before advising her to take tamoxifen. A new trial (Study of Tamoxifen And Raloxifene, STAR) will compare tamoxifen with raloxifene for their effectiveness in reducing breast cancer and for side effects. West Virginia women participated in the BCPT and will be able to participate in the STAR trial through centers in Morgantown and Charleston.
乳腺癌是美国女性主要的健康问题。几个因素决定了女性患乳腺癌的风险,包括年龄、遗传、激素暴露等。通过使用一种名为盖尔模型的统计模型,可以估计女性患乳腺癌的风险。利用该模型,乳腺癌预防试验(BCPT)发现,乳腺癌高危女性服用他莫昔芬可使乳腺癌发病率降低49%。他莫昔芬治疗的严重副作用几乎只出现在50岁以上的女性中。因此,50岁以下的乳腺癌高危女性最有可能从服用他莫昔芬五年中获益。因此,在建议每位女性服用他莫昔芬之前,应进行利弊评估。一项新的试验(他莫昔芬与雷洛昔芬研究,STAR)将比较他莫昔芬和雷洛昔芬在降低乳腺癌方面的有效性以及副作用。西弗吉尼亚州的女性参与了BCPT,并且将能够通过摩根敦和查尔斯顿的中心参与STAR试验。