Current Research in Breast Cancer
Because of the incidence, significant mortality, and lack of a cure, breast cancer survivors, advocates, and activists have brought social and political attention to this disease and put it in the national spotlight. Activists have demanded and obtained in-creased federal funding for a national program aimed at finding a cure for breast cancer.
Preventing the development of cancer through the use of medications is a relatively new and exciting area of research. In April 1998, the results of the Breast Cancer Prevention Trial were released to the general public. This nationwide, randomized, double-blind, placebo-controlled clinical trial evaluated tamoxifen (Nolvadex) versus a placebo in more than 13,000 women con-sidered to be at high risk for the development of breast cancer. The women who received tamoxifen had a 45% reduction in the incidence of breast cancer (Fisher et al., 1998). These results sug-gested that tamoxifen was an effective chemopreventive agent. Much attention has been focused on this medication, and it is now available with FDA approval for high-risk women. Clini-cians are still unclear, however, about who should receive the medication, and no consensus exists. Nurses can provide infor-mation to patients on the benefits, risks, and possible side effects of tamoxifen to help women in considering this option.
Another agent that shows promise for chemoprevention is raloxifene (Evista). This medication is FDA approved for the pre-vention of osteoporosis; however, in the studies that have been performed, incidental findings indicated that fewer of the women who received raloxifene developed breast cancer (Cummings, Eckert, Kreuger et al., 1999). This has led to the hypothesis that this drug may also be an effective chemopreventive agent. Re-searchers are conducting another nationwide, randomized clinical trial, the Study of Tamoxifen and Raloxifene, which is comparing these two agents in postmenopausal women for the prevention of breast cancer. Twenty-two thousand women are needed for this trial, so results will not be available until later in the decade.
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