Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 22;5(1):pkaa125.
doi: 10.1093/jncics/pkaa125. eCollection 2021 Feb.

Chemoprevention Agents to Reduce Mammographic Breast Density in Premenopausal Women: A Systematic Review of Clinical Trials

Ana S Salazar  1 , Malika Rakhmankulova  1 , Laura E Simon  2 , Adetunji T Toriola  1
Affiliations

Chemoprevention Agents to Reduce Mammographic Breast Density in Premenopausal Women: A Systematic Review of Clinical Trials

Ana S Salazar et al. JNCI Cancer Spectr. .

Abstract

Background: Higher mammographic breast density (MBD) is associated with an increased risk of breast cancer when compared with lower MBD, especially in premenopausal women. However, little is known about the effectiveness of chemoprevention agents in reducing MBD in premenopausal women without a history of breast cancer. Findings from this review should provide insight on how to target MBD in breast cancer prevention in premenopausal women with dense breasts.

Methods: We searched 9 electronic databases for clinical trials in English, Spanish, French, or German published until January 2020. Articles evaluating the association of pharmacological agents and MBD were included. Data were extracted on methods, type and dose of intervention, outcomes, side effects, and follow up. Quality of the studies was assessed using the US Preventive Services Task Force criteria.

Results: We identified 7 clinical trials evaluating the associations of 6 chemoprevention agents with changes in MBD in premenopausal women without history of breast cancer. The studies evaluated selective estrogen-receptor modulators (n = 1); gonadotropin-releasing hormone agonists (n = 2); isoflavones (n = 1); vitamin D (n = 1); and Boswellia, betaine, and mayo-inositol compound (n = 1). Hormonal interventions were associated with net reductions in percent density (tamoxifen [13.4%], leuprolide acetate [8.9%], and goserelin [2.7%]), whereas nonhormonal (vitamin D and isoflavone) interventions were not. However, MBD returned to preintervention baseline levels after cessation of gonadotropin-releasing hormone agonists.

Conclusions: A limited number of chemoprevention agents have been shown to reduce MBD in premenopausal women. Identification of new and well-tolerated chemoprevention agents targeting MBD and larger studies to confirm agents that have been studied in small trials are urgent priorities for primary breast cancer prevention in premenopausal women with dense breasts.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flow diagram for included studies by preferred reporting items for systematic review and meta-analyses
See this image and copyright information in PMC

Comment in

References

    1. Johnson RH, Chien FL, Bleyer A.. Incidence of breast cancer with distant involvement among women in the United States, 1976 to 2009. JAMA. 2013;309(8):800–805. - PubMed
    1. Anders CK, Johnson R, Litton J, Phillips M, Bleyer A.. Breast cancer before age 40 years. Semin Oncol. 2009;36(3):237–249. - PMC - PubMed
    1. Fredholm H, Magnusson K, Lindstrom LS, et al. Breast cancer in young women and prognosis: How important are proliferation markers? Eur J Cancer. 2017;84:278–289. - PubMed
    1. Sestak I, Cuzick J.. Breast cancer chemoprevention. Oncol Rev. 2008;2(4):223–228.
    1. McCormack VA, dos Santos Silva I.. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2006;15(6):1159–1169. - PubMed

Publication types

MeSH terms

LinkOut - more resources