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For postmenopausal women with ductal carcinoma in situ (DCIS) where optimal local control or patient preference results in mastectomy, despite substantial risk of contralateral invasive breast cancer, tamoxifen is uncommonly prescribed based on unfavorable risk-benefit consideration. In the National Cancer Institute of Canada Clinical Trial Group (NCIC CTG) MAP.3 primary prevention trial, in postmenopausal women exemestane reduced invasive breast cancer incidence by 65% without increasing life-threatening side effects. In adjuvant breast cancer trials, the aromatase inhibitor exemestane as well as anastrozole and letrozole have all reduced new contralateral breast cancer incidence. Thus, aromatase inhibitors, and perhaps particularly exemestane, provide an option to address the risk of contralateral breast cancer in postmenopausal women with DCIS managed with mastectomy.
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, California University of New England, College of Osteopathic Medicine and Shared Decision Making Resources Georgetown, Maine, USA.
This article was published in the following journal.
Name: The breast journal
There are increasing rates of mastectomy and bi-lateral mastectomy in women diagnosed with ductal carcinoma in situ (DCIS). To help women avoid decisions that lead to unnecessary aggressive treatments...
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A gonadal stromal neoplasm composed only of THECA CELLS, occurring mostly in the postmenopausal OVARY. It is filled with lipid-containing spindle cells and produces ESTROGENS that can lead to ENDOMETRIAL HYPERPLASIA; UTERINE HEMORRHAGE; or other malignancies in postmenopausal women and sexual precocity in girls. When tumors containing theca cells also contain FIBROBLASTS, they are identified as thecoma-fibroma tumors with less active hormone production.
Total mastectomy with axillary node dissection, but with preservation of the pectoral muscles.
A nonhormonal medication for the treatment of postmenopausal osteoporosis in women. This drug builds healthy bone, restoring some of the bone loss as a result of osteoporosis.
Metabolic disorder associated with fractures of the femoral neck, vertebrae, and distal forearm. It occurs commonly in women within 15-20 years after menopause, and is caused by factors associated with menopause including estrogen deficiency.
Radical mastectomy with removal of the ipsilateral half of the sternum and a portion of ribs two through five with the underlying pleura and the internal mammary lymph nodes.
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