Selective estrogen receptor modulators (SERMS), such as tamoxifen, are widely used to prevent the recurrence of breast cancer in women who have been treated for the disease. SERMs are drugs that may block or accentuate the action of estrogen, depending on the tissue being examined. Tamoxifene and raloxifene, for example, inhibit the action of estrogen on breast tissue.
Until recently, however, it was not clear how long the protective effect would last. A study published in The Lancet analyzed the results of nine randomized trials of over 83,000 women who used a SERM for a median follow-up period of 65 months. Four different SERMs were involved in the studies, and the participants had breast cancer risk levels between normal and high.
In most of the studies, the women used their drug for five years. The authors of the meta-analysis found that SERM use was associated with a 38 percent reduction in the overall risk of breast cancer compared to controls for ten years a highly significant difference. When the effects on estrogen-positive breast cancers were examined, the results were even better the risk was diminished by 48 percent.
As with many pharmaceutical treatments, there are other risks and benefits associated with the use of SERMs there is an increased risk of thromboembolic events (blood clots that could travel from the legs to the lungs, for example), but a decreased risk of vertebral fractures.
The authors noted , however, their longer assessment of the drugs actions indicate the benefit-harm balance is now more favorable than that calculated for short-term follow-up.
ACSH s Dr. Gilbert Ross comments, We have encouraged the more extensive use of SERMs for breast cancer prevention, and these data fully support that position.
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