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


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.

SUBMITTER: Shawky MS 

PROVIDER: S-EPMC5354931 | biostudies-other | 2017 Jan

REPOSITORIES: biostudies-other

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

Shawky Michael S MS   Martin Hilary H   Hugo Honor J HJ   Lloyd Thomas T   Britt Kara L KL   Redfern Andrew A   Thompson Erik W EW  

Oncotarget 20170101 3


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 sett  ...[more]

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