dc.contributor.author | Esserman, Laura J | |
dc.contributor.author | Ozanne, Elissa M. | |
dc.contributor.author | Dowsett, Mitch | |
dc.contributor.author | Slingerland, Joyce M | |
dc.date.accessioned | 2011-04-28T04:16:11Z | |
dc.date.issued | 2005 | |
dc.identifier.citation | Esserman, Laura J., Elissa M. Ozanne, Mitch Dowsett, and Joyce M. Slingerland. 2005. Tamoxifen may prevent both ER+ and ER- breast cancers and select for ER- carcinogenesis: an alternative hypothesis. Breast Cancer Research 7(6): R1153-R1158. | en_US |
dc.identifier.issn | 1465-5411 | en_US |
dc.identifier.uri | http://nrs.harvard.edu/urn-3:HUL.InstRepos:4878920 | |
dc.description.abstract | Introduction: Breast Cancer Prevention Trial (BCPT) and Multiple Outcomes of Raloxifene (MORE) data have been interpreted to indicate that tamoxifen reduces the risk of ER+ but not ER- breast carcinogenesis. We explored whether these data also support an alternative hypothesis, that tamoxifen influences the natural history of both ER+ and ER- cancers, that it may be equally effective in abrogating or delaying ER- and ER+ carcinogenesis, and place selection pressure, in some cases, for the outgrowth of ER- cancers. Methods: BCPT and MORE data were used to investigate whether: first, tamoxifen could reduce equally the emergence of ER- and ER+ tumors; and second, tamoxifen could select a fraction of emerging ER+ cancers and promote their transformation to ER- cancers. Assuming that some proportion, Z, of ER+ tumors becomes ER- after tamoxifen exposure and that the risk reduction for both ER- and ER+ tumors is equal, we solved for both the transformation rate and the risk reduction rate. Results: If tamoxifen equally reduces the incidence of ER+ and ER- tumors by 60%, the BCPT results are achieved with a transformation of approximately Z = 20% of ER+ to ER- tumors. Validation with MORE data using an equal risk reduction of 60% associated with tamoxifen produces an almost identical transformation rate Z of 23%. Conclusion: Data support an alternative hypothesis that tamoxifen may promote ER- carcinogenesis from a precursor lesion that would otherwise have developed as ER+ without tamoxifen selection. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | BioMed Central | en_US |
dc.relation.isversionof | doi:10.1186/bcr1342 | en_US |
dc.relation.hasversion | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1410777/pdf/ | en_US |
dash.license | LAA | |
dc.title | Tamoxifen may prevent both ER+ and ER- breast cancers and select for ER- carcinogenesis: an alternative hypothesis | en_US |
dc.type | Journal Article | en_US |
dc.description.version | Version of Record | en_US |
dc.relation.journal | Breast Cancer Research | en_US |
dash.depositing.author | Ozanne, Elissa M. | |
dc.date.available | 2011-04-28T04:16:11Z | |
dash.affiliation.other | HMS^Radiology-Massachusetts General Hospital | en_US |
dc.identifier.doi | 10.1186/bcr1342 | * |
dash.contributor.affiliated | Ozanne, Elissa M. | |