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Home: Oncology Leader Commentary: Monica Morrow, MD

Click on the topic below for comments by Dr Monica Morrow to comment on. You will also find links to related articles and clinical trials.

Putting DCIS in perspective
NSABP B-17: Role of radiotherapy in DCIS
NSABP B-17: Benefits of radiotherapy in DCIS
Silverstein’s approach to radiation
NSABP B-24: Role tamoxifen
Benefits of tamoxifen in DCIS subsets
A model of DCIS management
Mortality and DCIS
DCIS summary
Atypical hyperplasia
Assessment of patients with AH
Intervention options with AH
NSABP PTamoxifen in AH

Excision alone for DCIS

Assessment of patients with AH

Presentation, 22nd annual San Antonio Breast Cancer Symposium
(Source: Breast Cancer Update for Surgeons, Program 1 2000)

Play Audio Below:

The first thing you want to do is make a thorough assessment of their level of risk using known breast cancer risk factors. And because there has been a lot of controversy in the literature about the ability of pathologists to diagnose atypical hyperplasia, we know that if they use a standard set of criteria, they will reproducibly make this diagnosis by and large, or at least in 77 percent of cases. If you don’t see a lot of benign breast pathology ¾ if you have uncertainties ¾ a second opinion is a useful thing. Secondly, as you would with any high-risk woman, you need to find out what is concerning her. Is it fear of breast cancer death? Is it fear of surgery? How does this impact upon quality of life?

Relevant Articles:

Tamoxifen should be cost-effective in reducing breast cancer risk in high-risk women
Smith, T. J. and Hillner, B. E.. Journal of Clinical Oncology. 18(2):284-286, 2000 Jan.

Estimation of tamoxifen's efficacy for preventing the formation and growth of breast tumors.
Radmacher, M.D., Simon, R. -- (Reprint available from: Radmacher MD NIH 7550 Wisconsin Ave,MS 9015 Bethesda, MD 20892 USA).. Journal of the National Cancer Institute. 92(1):48-53, 2000 Jan 5.

Tamoxifen and risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers: a case-control study
Narod, S. A.; Brunet, J. S.; Ghadirian, P.; Robson, M.; Heimdal, K.; Neuhausen, S. L.; Stoppa-Lyonnet, D.; Lerman, C.; Pasini, B.; de los Rios, P.; Weber, B., and Lynch, H.. Lancet. 356(9245):1876-1881, 2000 Dec 2.

Chemoprevention options for BRCA1 and BRCA2 mutation carriers.
Eeles, R. A. and Powles, T. J. Journal of Clinical Oncology. 18(21 Suppl S):93S-99S, 2000 Nov 1.

Chemoprevention of breast cancer [Review].
Brown, P. H. and Lippman, S. M. (Reprint available from: Lippman SM Univ Texas, MD Anderson Canc Ctr, Dept Clin Canc Prevent 1515 Holcombe Blvd,Box 236 Houston, TX 77030 USA). Breast Cancer Research & Treatment. 62(1):1-17, 2000 Jul.

Hormonal approaches to the chemoprevention of endocrine-dependent tumors.
Manni, A.. Endocrine-Related Cancer. 6(4):483-485, 1999 Dec.

Pilot trial of the safety, tolerability, and retinoid levels of N-(4-hydroxyphenyl) retinamide in combination with tamoxifen in patients at high risk for developing invasive breast cancer.
Conley, B.; O'Shaughnessy, J.; Prindiville, S.; Lawrence, J.; Chow, C.; Jones, E.; Merino, M. J.; Kaiser-Kupfer, M. I.; Caruso, R. C.; Podger, M.; Goldspiel, B.; Venzon, D.; Danforth, D.; Wu, S. L.; Noone, M.; Goldstein, J.; Cowan, K. H., and Zujewski, J.. Journal of Clinical Oncology. 18(2):275-283, 2000 Jan.

Vitamin A analogue for breast cancer prevention: a grade of F or incomplete? Response
Piantadosi, S. (Reprint available from: Piantadosi S Johns Hopkins Univ, Sch Med, Johns Hopkins Oncol Ctr 550 N Broadway,Suite 1103 Baltimore, MD 21205 USA).. Journal of the National Cancer Institute. 92(3):274-275, 2000 Feb 2. No abstract

Tamoxifen for the prevention of breast cancer in the high-risk woman.
Morrow, M. and Jordan, V. C. (Reprint available from: Morrow M 676 N St Clair St,13th Floor, Room 13-104 Chicago, IL 60611 USA).. Annals of Surgical Oncology. 7(1):67-71, 2000 Jan-Feb. No abstract

Relevant Clinical Trials:

Study of Tamoxifen and Raloxifene (STAR) for the Prevention of Breast Cancer

Randomized, Double-Blind, Placebo-Controlled Study of Tamoxifen for the Prevention of Breast Cancer in High-Risk Women: International Breast Cancer Intervention Study

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