Mammographic density: A potential monitoring biomarker for adjuvant and preventative breast cancer endocrine therapies
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2017-01-01
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Oncotarget
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IMPACT JOURNALS LLC
Melbourne Authors
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Surgery (St Vincent's)
Sir Peter MacCallum Department of Oncology
Sir Peter MacCallum Department of Oncology
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Journal Article
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Shawky, M. S., Martin, H., Hugo, H. J., Lloyd, T., Britt, K. L., Redfern, A. & Thompson, E. E. W. (2017). Mammographic density: A potential monitoring biomarker for adjuvant and preventative breast cancer endocrine therapies. Oncotarget, 8 (3), pp.5578-5591. https://doi.org/10.18632/oncotarget.13484.
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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.