A lower dose of tamoxifen may reduce the risk of breast cancer

While the drug tamoxifen reduces the risk of developing breast cancer and prevents recurrence, the side effects cause many women to stop their treatment.

A study by researchers at Karolinska Institutet in Sweden has now found that a dose much lower than normal has a positive effect with fewer adverse reactions. the women who have not yet entered menopause. The study, published in the Journal of Clinical Oncology, they can play a major role in the treatment of cancer.

The anti-hormone drug tamoxifen has been used for over 40 years to reduce the risk of relapse in women treated for hormone-related breast cancer. It is also approved as a prophylactic for women with a higher risk of breast cancer.

Women with dense breasts, that is to say breasts with relatively high levels of firbroglandular material to fatty tissue, run a four to six times higher risk for developing breast cancer. Both breast tightness and tumors appear white in mammograms, making it difficult to detect cancer. Tamoxifen reduces breast mammography density.

Harmful reactions

Despite the fact that tamoxifen reduces the risk of breast cancer by up to 40 percent, it is rarely used as a prophylactic for healthy women with an increased risk of the disease.

Nearly half of women who take tamoxifen to prevent recurrence after an obstruction stop premature treatment due to a number of known reactions, including symptoms such as menopausal disorders, diabetes, insomnia and various genetic disorders.

Radiologists, oncologists and researchers at the Stockholm Södersjukhuset Breast Center, Lund University and Karolinska Institutet have studied the effects of tamoxifen on breast density at doses lower than the usual 20 mg.

Lower doses of tamoxifen

The Karisma study began in 2016 and monitored 1,440 women between the ages of 40 and 74 for just under three years. The women were randomly assigned to six groups of 240, five experimental groups who received a specific dose of tamoxifen (1 2.5, 5, 10 or 20 mg) as well as a placebo group.

Before and after the six-month treatment, their mammographic breast density was compared. The women were also asked to report any side effects on a specially designed app.

Tamoxifen has been shown to reduce mammographic density in women and may be seen as a surrogate for medical response. The established dose of tamoxifen is 20 mg, but it turned out that 2.5, 5 and 10 mg reduced the concentration by as much as 20 mg. At the same time, the side effects reported by the 2.5 mg group were reduced by 50 percent compared to women who received the 20 mg dose. “

Per Hall, Principal Investigator and Professor, Department of Medical Epidemiology and Biostatistics, Karolinska Institute

The next step for the researchers is to find out if 2.5 mg tamoxifen also reduces the risk of developing breast cancer so it can be used to prevent both first and foremost recurrence. -circulation.

“Such a dose reduction could increase the number of patients who complete their treatment,” he says.

AI analysis of mammograms

There are currently no protective strategies to reduce breast cancer except a small group of women with increased risk of heredity. Per Hall welcomes further work on prophylactic therapies:

“One of the problems is that there is no appropriate medication. Another is that there is no effective way to identify women who are at high risk of breast cancer. We are currently involved in a project in which we use AI, Artificial Intelligence, to study mammographic images to detect changes that identify women who develop breast cancer. “