HY 11/06: A Better Drug for Preventing Breast Cancer?

What you need to know about raloxifene

Breast Cancer Risk Factors

Age over 50
Family history of breast or ovarian cancer on mother’s or father’s side, especially first-degree relatives (mother, sister, daughter)
Menstruation before age 12 or menopause after age 55
No children or first child after age 30
Several years of hormone replacement therapy, especially combined estrogen/progesterone
Alcohol use (risk rises with daily amount consumed)
Obesity, high-fat diet, lack of exercise, especially after menopause

Because of her faith, Betty Heckman, 77, of Allentown never worried about breast cancer despite her four biopsies and numerous cysts (all benign). Yet when she saw a Healthy You story several years ago about a clinical trial and how it could help women manage their breast cancer risk, she took action.

“I had to help others and maybe even myself by getting involved in the trial,” Heckman (pictured at right) says. “Research is the only way to discover new treatments.”

Heckman—and 19,746 other women—took part in the STAR (Study of Tamoxifen and Raloxifene) trial. Initial results, released in April, shared the news that the osteoporosis drug raloxifene was just as effective as the tried-and-true cancer drug tamoxifen in reducing breast cancer risk for high-risk postmenopausal women. Even better, raloxifene didn’t appear to cause as many serious side effects, such as uterine cancer and blood clots.

Then the controversy started. The findings on uterine cancer were not “statistically significant,” said the news media reports—in other words, the difference in uterine cancer occurrences was so small it could have happened by chance.

What should women believe? “Overall, raloxifene appears to be the safer drug,” says Gregory Harper, M.D., breast cancer specialist at Lehigh Valley Hospital and Health Network. “These news stories sometimes stir up controversy and don’t focus on the results, which speak for themselves. The prevention benefit is equal in both drugs, while raloxifene causes fewer side effects overall.”

If you think you’re at increased risk for breast cancer (see box at right), talk with your doctor about which medication—if any—is right for you. “If I suspect a woman is at risk, I recommend that she get genetic counseling before prescribing anything,” says Harper’s colleague, gynecologist Alexandria George, D.O. “I also ask her if she’s tracking her breast health with monthly self-exams and annual mammograms.”

If you and your doctor decide a drug would be a good strategy, the next step is to look at your options. “If you also have osteoporosis, raloxifene might be the best choice,” says Deborah Kane, R.N., clinical trials study coordinator at the hospital. “But if you’re premenopausal, tamoxifen is the way to go.”

“Raloxifene gives women a choice,” Harper says. “It’s another tool in our fight to prevent breast cancer.”

Want to Know More about Lehigh Valley Hospital’s cancer risk assessment program or how to do a breast self-exam? Click on the links in the column on the right side of this page. For more on an upcoming breast cancer prevention clinical trial, call 610-402-CARE.