Hi suzanne666666,
Thank you for your question.
Please keep in mind that this answer is for information purposes only, and is
not intended to diagnose, treat or replace sound medical advice from
your physician or health care provider. See *Important Disclaimer* at
bottom of page.
NCCN: Measure Estrogen Receptor Status in DCIS - HOLLYWOOD, FL --
March 15, 2004 By Mark Fuerst
http://www.docguide.com/news/content.nsf/news/8525697700573E1885256E580065FD8D
"Women with ductal carcinoma in situ (DCIS) should have their estrogen
receptor status evaluated, according to new breast cancer guidelines.
The 8th annual update of breast cancer guidelines by the National
Comprehensive Cancer Center now calls for a determination of tumor
estrogen receptor status for DCIS patients. The guidelines were
released here on March 11th at the NCCN's 9th Annual Conference on
Clinical Practice Guidelines and Outcomes Data in Oncology.
Hormone receptor status provides stronger support for the use of
tamoxifen in DCIS patients," said Stephen E. Edge, MD, chair of the
department of breast and soft tissue surgery at Roswell Park Cancer
Institute, Buffalo, New York. Data from the NSABP-24 trial of more
than 1,800 women with breast cancer show that, among women who took
tamoxifen, those with positive estrogen receptor status had about half
the relative risk of recurrence compared to those with negative
estrogen receptor status.
The updated NCCN guidelines suggest the use of tamoxifen for 5 years
for patients treated with breast-conserving surgery (lumpectomy) and
radiation therapy, especially for those with positive estrogen
receptor DCIS. The benefit of tamoxifen for those with negative
estrogen receptor DCIS is uncertain, said Dr. Edge."
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4Woman.Gov - The National Women's Health Information Center
http://www.4woman.gov/faq/earlybc.htm
Early Stage Breast Cancer: A Patient and Doctor Dialogue
"I have heard that some tumors are "estrogen receptor-positive?" What
does that mean? If my tumor is estrogen receptor-positive, should that
make a difference in my treatment?
Some breast cancers are sensitive to the female hormone, estrogen, and
are called "estrogen receptor-positive." The drug tamoxifen interferes
with estrogen and when breast cancer cells are sensitive to estrogen,
tamoxifen can inhibit their growth.
Studies have shown that tamoxifen improves the chances of survival and
helps prevent recurrence of breast cancer, if the cancer cells are
estrogen receptor-positive. Tamoxifen is not an effective treatment
for breast cancer that is estrogen receptor-negative, and therefore
should not be taken for those cancers. Tamoxifen may have unpleasant
side effects that are similar to menopause, such as hot flashes,
vaginal dryness, irregular periods, and weight gain. Tamoxifen also
slightly increases the risk of uterine cancer and blood clots. Studies
suggest that Tamoxifen should not be taken for more than five years."
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BreastCancer.org
http://www.breastcancer.org/research_hormonal_120002c.html
Women with Estrogen-Receptor-Positive Non-Invasive Disease (DCIS) Get
Significant Benefit from Tamoxifen
San Antonio Breast Cancer Symposium, December 2002, Abstract #30
Allred D, et al.
"Past studies have shown that women with DCIS benefit from taking
tamoxifen in two ways:
- Tamoxifen reduces the risk of DCIS coming back.
- Tamoxifen reduces the possibility that a woman with DCIS will
develop a first-time invasive cancer in either breast.
But doctors still aren't sure whether tamoxifen offers the same
benefit for all women with DCIS, or only for women with
estrogen-receptor-positive DCIS (DCIS that needs estrogen to grow).
The study described here tried to answer this question.
Study design: Between 1991 and 1994, more than 1,800 women diagnosed
with DCIS were treated with lumpectomy and radiation. Half then
received five years of treatment with tamoxifen, and half were treated
for five years with a placebo (a sugar pill that looked like
tamoxifen).
Researchers determined the estrogen-receptor status for more than 600
of the women.
Results: For the women with estrogen-receptor-positive DCIS, the
effectiveness of tamoxifen was clear. Women in this group who took
tamoxifen were significantly less likely to develop a new cancer in
either breast than those who did not take tamoxifen. The relative risk
reduction for women who took tamoxifen compared to women who didn't
was 59%.
For the women with estrogen-receptor-negative DCIS, the benefit of
tamoxifen seemed to be very small. But the number of women with
estrogen-receptor-negative tumors in this study who went on to develop
a new cancer was too small to reach a definite conclusion.
Conclusion: The women in this study with estrogen-receptor-positive
DCIS clearly reduced their risk of developing an invasive breast
cancer by taking tamoxifen. The results for women with
estrogen-receptor-negative DCIS were not clear. More studies are
needed to see whether women with this type of disease may benefit from
tamoxifen."
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SusanLoveMD.org - Tamoxifen
http://www.susanlovemd.org/faq/tamoxifen/tamoxifen_5.html
"... you should request that the DCIS be tested for estrogen receptors
as there is recent data from a small study that suggests that women
whose DCIS is not estrogen-receptor (ER) positive do not have a
beneficial effect from tamoxifen.
Tamoxifen began to be routinely offered to women for DCIS in 1999,
after researchers reported the results of a study designed to test
whether adding tamoxifen to DCIS treatment had additional value. The
study randomized 1,804 women who had been treated for DCIS to
tamoxifen or a placebo for five years. All of the women had already
been treated with excision followed by radiation therapy. Their tumors
were not tested for estrogen receptors, and it was assumed that most
of them were estrogen receptor positive. Since the 2002 San Antonio
Breast Cancer Symposium, where research was presented on the
importance of testing for estrogen receptors in DCIS, future research
would likely test the receptors.
After following the women for five years, the researchers found that:
Forty women in the placebo group and 23 in the tamoxifen group
developed subsequent invasive cancers in the treated breast. This
meant that, statistically, tamoxifen reduced the chance of developing
invasive cancer from 4.2 percent to 2.1 percent."
(see rest of article)
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Best regards,
tlspiegel |
