Chemoprevention Agents to Reduce Mammographic Breast Density in Premenopausal Women: A Systematic Review of Clinical Trials.
Chemoprevention Agents to Reduce Mammographic Breast Density in Premenopausal Women: A Systematic Review of Clinical Trials.
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DOI：
10.1093/jncics/pkaa125
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发表时间：
2021-03
影响因子：
4.4
通讯作者：
Toriola AT
中科院分区：
文献类型：
--
作者：
Salazar AS;Rakhmankulova M;Simon LE;Toriola AT
乳腺摄影乳腺密度（MBD）较高与乳腺癌的风险增加相比，MBD较低，尤其是在绝经前妇女。然而，很少有人知道的有效性化学预防剂在减少MBD绝经前妇女没有乳腺癌的历史。本综述的结果应提供关于如何在绝经前致密乳腺妇女中靶向MBD预防乳腺癌的见解。我们检索了截至2020年1月发表的9个英文、西班牙文、法文或德文临床试验电子数据库。纳入了评价药物与MBD相关性的文章。数据提取的方法，类型和剂量的干预，结果，副作用和随访。使用美国预防服务工作组标准评估研究质量。我们确定了7项临床试验，评估6种化学预防剂与无乳腺癌病史的绝经前妇女MBD变化的相关性。这些研究评价了选择性雌激素受体调节剂（n = 1）;促性腺激素释放激素激动剂（n = 2）;孕酮（n = 1）;维生素D（n = 1）;乳香、甜菜碱和蛋黄酱肌醇化合物（n = 1）。激素干预与密度百分比的净降低相关（他莫昔芬[13.4%]、醋酸亮丙瑞林[8.9%]和戈舍瑞林[2.7%]），而非激素（维生素D和维生素E）干预则与此无关。然而，在停止促性腺激素释放激素激动剂后，MBD恢复到干预前的基线水平。有限数量的化学预防剂已被证明可以减少绝经前妇女的MBD。确定新的和耐受性良好的化学预防药物靶向MBD和更大的研究，以确认已在小型试验中研究的药物是绝经前致密乳腺妇女的主要乳腺癌预防的紧迫优先事项。
Higher mammographic breast density (MBD) is associated with an increased risk of breast cancer when compared with lower MBD, especially in premenopausal women. However, little is known about the effectiveness of chemoprevention agents in reducing MBD in premenopausal women without a history of breast cancer. Findings from this review should provide insight on how to target MBD in breast cancer prevention in premenopausal women with dense breasts. We searched 9 electronic databases for clinical trials in English, Spanish, French, or German published until January 2020. Articles evaluating the association of pharmacological agents and MBD were included. Data were extracted on methods, type and dose of intervention, outcomes, side effects, and follow up. Quality of the studies was assessed using the US Preventive Services Task Force criteria. We identified 7 clinical trials evaluating the associations of 6 chemoprevention agents with changes in MBD in premenopausal women without history of breast cancer. The studies evaluated selective estrogen-receptor modulators (n = 1); gonadotropin-releasing hormone agonists (n = 2); isoflavones (n = 1); vitamin D (n = 1); and Boswellia, betaine, and mayo-inositol compound (n = 1). Hormonal interventions were associated with net reductions in percent density (tamoxifen [13.4%], leuprolide acetate [8.9%], and goserelin [2.7%]), whereas nonhormonal (vitamin D and isoflavone) interventions were not. However, MBD returned to preintervention baseline levels after cessation of gonadotropin-releasing hormone agonists. A limited number of chemoprevention agents have been shown to reduce MBD in premenopausal women. Identification of new and well-tolerated chemoprevention agents targeting MBD and larger studies to confirm agents that have been studied in small trials are urgent priorities for primary breast cancer prevention in premenopausal women with dense breasts.
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DOI：
10.1158/1940-6207.capr-15-0109
发表时间：
2015-12
期刊：
Cancer prevention research (Philadelphia, Pa.)
影响因子：
--
作者：
Fabian CJ;Kimler BF;Zalles CM;Phillips TA;Metheny T;Petroff BK;Havighurst TC;Kim K;Bailey HH;Heckman-Stoddard BM
通讯作者：
Heckman-Stoddard BM
影响因子：
5.6
作者：
El-Bastawissi, AY;White, E;Taplin, S
通讯作者：
Taplin, S
影响因子：
3.7
作者：
Chen M;Rao Y;Zheng Y;Wei S;Li Y;Guo T;Yin P
通讯作者：
Yin P
影响因子：
3.9
作者：
Folkerd, Elizabeth;Dowsett, Mitch
通讯作者：
Dowsett, Mitch
影响因子：
3
作者：
Bertrand, Kimberly A.;Eliassen, A. Heather;Tamimi, Rulla M.
通讯作者：
Tamimi, Rulla M.