title: Prospects for the primary prevention of breast cancer.
abstract: In this paper, the rationale, stage of development, and known or potential adverse effects of three potential strategies for the prevention of breast cancer are reviewed. Two methods--the use of tamoxifen in postmenopausal women and the use of luteinizing hormone (LH)-releasing hormone agonists in premenopausal women--involve hormonal manipulation. In the premenopausal period, the goal is to reduce the number of ovulatory menstrual cycles a woman experiences in order to reduce her exposure to estrogen and progesterone. Physical activity during adolescence is proposed as a nonhormonal method of accomplishing this. The use of LH-releasing hormone agonists to produce a reversible menopause can also reduce a woman's cumulative exposure to ovarian steroid hormones. Tamoxifen, which is effective in breast cancer therapy, provides endocrine control of estrogen-regulated breast tumor growth. Breast cancer chemoprevention trials using tamoxifen among postmenopausal women have been proposed, and pilot studies are under way.
authors.affiliation: Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles 90033.
authors.forename: L
authors.initials: L
authors.lastname: Bernstein
authors.forename: R K
authors.initials: RK
authors.lastname: Ross
authors.forename: B E
authors.initials: BE
authors.lastname: Henderson
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000503:physiopathology / Q000517:prevention & control*; D004965:Estrogen Antagonists / Q000627:therapeutic use*; D015444:Exercise / Q000502:physiology; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000502:physiology*; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects; D008875:Middle Aged; D010060:Ovulation / Q000187:drug effects; D011374:Progesterone / Q000037:antagonists & inhibitors; D011966:Receptors, LHRH / Q000187:drug effects; D013629:Tamoxifen / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D004965:Estrogen Antagonists; D011966:Receptors, LHRH; D013629:Tamoxifen; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone