Medical Oncology

Cancer Prevention

Questions discussed in this category

How do you decide among AI, full dose tamoxifen and low dose tamoxifen in a postmenopausal woman with DCIS without contraindications to either therapy?

1 Answer available

How do you counsel patients on semaglutide or tirzepatide in light of potential cancer risks?

Do you avoid using these agents only in patients with history of medullary thyroid cancer or pancreatic cancer? Are there other cancer risks we should...

1 Answer available

When do you recommend endocrine therapy for chemoprevention in women with high-risk benign breast lesions?

1 Answer available

Is there safety data regarding the use of hormonal IUDs in patients with atypical ductal hyperplasia and other high risk, non-malignant breast lesions?

1 Answer available

How would you approach breast cancer screening in an adolescent patient with a CDH1 mutation?

1 Answer available

How do you approach a patient with discordant breast cancer risk prediction scores for prevention?

For example, if low GAIL and high Tyrer-Cuzick?

1 Answer available

Would you restart endocrine therapy for a patient with new contralateral LCIS diagnosed 2 years following completion of AI therapy for stage 1A HR+ IDC?

Would you restart hormonal therapy in a patient with a new diagnosis of LCIS 2 years after they have completed 5 yrs of AI for stage 1A IDC in the oth...

1 Answer available

When, if ever, would you recommend risk reducing BSO in patients with moderate penetrance breast cancer germline mutations?

Genes such as ATM, CHEK2, PALB2, RAD51C/D, BRIP1 seem to show some potential increased risk of ovarian cancer. Should these patients under prophylacti...

2 Answers available

For which non-BRCA pathogenic germline variants, if any, might you consider recommending chemoprevention with SERM/AI?

In a scenario where patient's other clinical/familial risk does not sufficiently qualify them? See JCO OGR 8/2021 by @Mark E. Robson discussing manag...

3 Answers available

How do you counsel patients on the efficacy of breast cancer risk reduction strategies such as breast MRI surveillance or bilateral mastectomy for those considered high risk by polygenic risk score, pathogenic variants, and/or family history?

Specifically do we know by how much each intervention reduces the risk of developing MBC or increase breast cancer specific as well as overall surviva...

3 Answers available

Would you recommend adjuvant tamoxifen in premenopausal woman with high grade DCIS and familial CHEK2 mutation who had bilateral mastectomies?

1 Answer available

How do you approach use of tamoxifen for chemo-prevention in post-menopausal women with non-BRCA germline mutations?

For instance, patients with ATM mutations

1 Answer available

How do you decide which lab to use for multi-gene hereditary testing?

Is there a difference among all the commercial genetic testing labs? Is there anything beyond CLIA- and CAP-certification that we should look for...

1 Answer available

Papers discussed in this category

NPJ breast cancer, 2016

Randomized trial of medroxyprogesterone acetate for the prevention of endometrial pathology from adjuvant tamoxifen for breast cancer: SWOG S9630.

Journal of the National Cancer Institute, 1998-09-16

Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study.

Lancet (London, England), 2002-09-14

First results from the International Breast Cancer Intervention Study (IBIS-I): a randomised prevention trial.

Journal of the National Cancer Institute, 2007-05-02

Tamoxifen for the prevention of breast cancer: late results of the Italian Randomized Tamoxifen Prevention Trial among women with hysterectomy.

Lancet,

Interim analysis of the incidence of breast cancer in the Royal Marsden Hospital tamoxifen randomised chemoprevention trial.

Annals of surgical oncology, 2010-10

Contralateral prophylactic mastectomy is associated with a survival advantage in high-risk women with a personal history of breast cancer.

Br J Cancer, 2014 Jun 10

Survival and contralateral breast cancer in CHEK2 1100delC breast cancer patients: impact of adjuvant chemotherapy.

Cochrane Database Syst Rev, 2010 Nov 10

Prophylactic mastectomy for the prevention of breast cancer.

J. Clin. Oncol., 2021 Aug 10

Management of Women With Breast Cancer and Pathogenic Variants in Genes Other Than BRCA1 or BRCA2.

Expert review of anticancer therapy, 2009-01

The NSABP Study of Tamoxifen and Raloxifene (STAR) trial.

Annals of the New York Academy of Sciences, 2001-12

The role of tamoxifen in breast cancer prevention: issues sparked by the NSABP Breast Cancer Prevention Trial (P-1).

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2013-01

Which risk model to use? Clinical implications of the ACS MRI screening guidelines.

AJR Am J Roentgenol, 2021 May 12

Distribution of Estimated Lifetime Breast Cancer Risk Among Women Undergoing Screening Mammography.

Cancer Prev Res (Phila), 2013 Aug 20

Assessing the breast cancer risk distribution for women undergoing screening in British Columbia.

Breast Cancer Res Treat, 2011 Oct 22

A systematic review of breast cancer incidence risk prediction models with meta-analysis of their performance.

BMC endocrine disorders, 2024 Nov 18

Risk of Hepatocellular Carcinoma with Glucagon-like Peptide-1 receptor agonist treatment in patients: a systematic review and meta-analysis.

International urology and nephrology, 2024 Nov 04

Effect of GLP-1 receptor agonists on prostate cancer risk reduction: a systematic review and meta-analysis.

Cancers, 2024 Sep 22