DUARTE, Calif., August 31, 2010 — The National Cancer Institute (NCI) has awarded City of Hope a five-year, $3.3 million grant to investigate whether a low daily dose of tamoxifen will decrease the risk of breast cancer among women who have been treated for Hodgkin’s lymphoma in childhood, adolescence or early adulthood. Melanie Palomares, M.D., M.S., assistant professor in the departments of Population Sciences and Medical Oncology & Therapeutics Research, will lead the study.
Young women whose treatment for Hodgkin’s lymphoma included radiation therapy to the chest have a 20- to 55-fold increased risk for developing breast cancer. The average woman has a 10 percent cumulative risk of developing breast cancer by age 80, but these women have a 20 percent cumulative risk of developing breast cancer by the much younger age of 45.
“Hodgkin’s lymphoma patients frequently get high-dose radiation to the chest, which is critical to the cure of their cancer — but it also contributes to the development of breast cancer,” said Palomares.
Tamoxifen interferes with estrogen in the body, and most breast cancers depend on estrogen to grow. Physicians already prescribe the drug to prevent breast cancer in other women at high risk, including women found to have precancerous lesions of the breast and those with breast cancer-related genetic mutations.
Although this drug is very effective, fear of side effects often keeps women from taking it. This study will look at a much lower dose, which has been shown to have promise, with fewer side effects.
Palomares and her colleagues will monitor mammographic density and levels of IGF-1, both markers associated with breast cancer risk, as well as reported symptoms and measures of blood and bone health among women in their study. Women also may choose to undergo random fine-needle aspiration, a procedure that samples breast cells so that researchers may look for evidence of abnormalities that might lead to cancer.
The study involves 300 healthy, female Hodgkin’s lymphoma survivors at five institutions across the U.S. and Canada who received radiotherapy for lymphoma before age 30. Other institutions participating in the study include St. Jude’s Children’s Research Hospital in Memphis, Tenn., Emory University School of Medicine in Atlanta, University of Michigan’s C.S. Mott Children’s Hospital in Ann Arbor, Mich., and Princess Margaret Hospital in Toronto.
Other City of Hope investigators in this study include Smita Bhatia, M.D., M.P.H, Ruth Ziegler Chair in Populations Sciences, and Lennie Wong, Ph.D., associate research scientist in the Department of Population Sciences.
