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Mammograms Might Show Drug Effectiveness

April 25, 2013
Written by: , Filed in: Breast Imaging
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Mammograms, by monitoring decreases in breast density, can measure the effectiveness of tamoxifen treatment in breast cancer patients, according to a new study published online Monday in the Journal of Clinical Oncology.

Tamoxifen is usually given over five years to prevent a relapse in women who have finished their primary breast cancer treatment. However, tamoxifen helps some women but not others. The drug is known to reduce breast density. The researchers wondered whether the amount of density reduction might indicate the drug’s effectiveness—or lack thereof.

The study subjects were 974 postmenopausal breast cancer patients, of whom 474 received tamoxifen and 500 did not. Each was given a baseline mammogram and a follow-up mammogram.

Over a 15-year follow-up period, tamoxifen patients whose follow-up mammograms showed a density reduction of at least 20 percent also were 50 percent less likely to die as a result of breast cancer.

“What’s needed is accurate measurement of mammographic density, which isn’t currently routine,” said Per Hall, MD, PhD, one of the study authors. Hall is a professor of medical epidemiology and biostatistics at Karolinska Institutet, a medical university in Stockholm. He was quoted in a Karolinska news release.

Performing a follow-up mammogram as a matter of course for women receiving tamoxifen could provide such an “accurate measurement.” That, in turn, might help prevent deaths, Dr. Hall said:

Measuring changes in density can be a simple and cheap means of assessing the effect of the treatment. if a patient is not responding to tamoxifen, maybe they should be given a different drug.

Interestingly, among women who did not take tamoxifen, there was no statistically significant association between survival and a change in breast density as measured by a mammogram. Apparently, a density decrease helps only if it’s induced by tamoxifen. One wonders why. Perhaps some researchers somewhere are trying to find out.

Related seminar: New Horizons in Breast Imaging


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