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Breast cancer drug passes test: exemestane may be used for prevention in healthy women.

A drug that inhibits the manufacture of estrogen can lower the likelihood of breast cancer among healthy women whom doctors consider at risk of developing the disease. The drug, called exemestane, may offer a preventive approach to combating the malignancy, researchers reported June 4 at a cancer meeting in Chicago and online in the New England Journal of Medicine.

Two drugs, tamoxifen and raloxifene, have previously been shown to lessen breast cancer risk when taken as preventives. Those drugs hamper the pro-growth effects of the hormone estrogen, which is implicated in most breast cancers. But while tamoxifen is commonly used as a treatment for breast cancer, few cancer-free women take it as a preventive even if they are deemed at risk.

Exemestane, a different kind of drug called an aromatase inhibitor, lessens the amount of estrogen made in the body.

In the new study, scientists enrolled 4,560 postmenopausal women at risk of breast cancer because of age, abnormal breast-cell growth or other factors. The researchers randomly assigned roughly half to get exemestane and half a placebo pill. After a median follow-up of 35 months, 11 invasive breast cancers had appeared in the exemestane group compared with 32 among the placebo recipients. Invasive breast cancer is dangerous because it spreads within the breast and is prone to jumping to nearby lymph nodes or to other organs.

The results suggest that taking an aromatase inhibitor such as exemestane reduces a woman's risk of developing invasive breast cancer by 65 percent, says study coauthor Paul Goss, a physician at Harvard Medical School in Boston.

While that rate indicates a substantial lessening of risk, the absolute annual incidence of breast cancers in each group was less than 1 percent. Hot flashes, sweating, fatigue and insomnia were slightly more common among women on exemestane, but women in both groups rated their overall quality of life similarly.

The findings "support the use of exemestane as an option for risk reduction in postmenopausal women at high risk for breast cancer," say Nancy Davidson and Thomas Kensler of the University of Pittsburgh, writing in a New England Journal of Medicine editorial. Exemestane is marketed as Aromasin by its maker Pfizer, which funded the study.

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Title Annotation:Body & Brain
Author:Seppa, Nathan
Publication:Science News
Geographic Code:1USA
Date:Jul 2, 2011
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