Work

Mammographic density: a potential monitoring biomarker for adjuvant and preventative breast cancer endocrine therapies

Year: 2016

Type: review

Abstract: // Michael S. Shawky 1,2 , Hilary Martin 3 , Honor J. Hugo 4,5 , Thomas Lloyd 6 , Kara L. Britt 7,8,9 , Andrew Redfern 3,* and Erik W. Thompson 4,5,10,* 1 Department of Head and Neck and Endocrine Surgery, Faculty of Medicine, University of Alexandria, Egypt 2 Department of Surgery, University College Hospital, London, UK 3 School of Medicine and Pharmacology, University of Western Australia, and Department of Medical Oncology, Fiona Stanley Hospital, Perth, Western Australia, Australia 4 Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Australia 5 Translational Research Institute, Brisbane, Australia 6 Department of Radiology, Princess Alexandra Hospital, Brisbane, Australia 7 The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia 8 Peter MacCallum Cancer Centre, Melbourne, Australia 9 Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia 10 Department of Surgery, University of Melbourne, St Vincent’s Hospital, Melbourne, Australia * These authors have contributed equally to this work Correspondence to: Erik W Thompson, email: // Keywords : mammographic density, breast cancer, endocrine therapy, predictive biomarker, surrogate Received : October 04, 2016 Accepted : October 08, 2016 Published : November 21, 2016 Abstract Increased mammographic density (MD) has been shown beyond doubt to be a marker for increased breast cancer risk, though the underpinning pathobiology is yet to be fully elucidated. Estrogenic activity exerts a strong influence over MD, which consequently has been observed to change predictably in response to tamoxifen anti-estrogen therapy, although results for other selective estrogen receptor modulators and aromatase inhibitors are less consistent. In both primary and secondary prevention settings, tamoxifen-associated MD changes correlate with successful modulation of risk or outcome, particularly among pre-menopausal women; an observation that supports the potential use of MD change as a surrogate marker where short-term MD changes reflect longer-term anti-estrogen efficacy. Here we summarize endocrine therapy-induced MD changes and attendant outcomes and discuss both the need for outcome surrogates in such therapy, as well as make a case for MD as such a monitoring marker. We then discuss the process and steps required to validate and introduce MD into practice as a predictor or surrogate for endocrine therapy efficacy in preventive and adjuvant breast cancer treatment settings.

Source: Oncotarget

DOI: 10.18632/oncotarget.13484