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Short-term changes in ultrasound tomography measures of breast density and treatment-associated endocrine symptoms after tamoxifen therapy.

dc.contributor.authorRamin, Cody
dc.contributor.authorPfeiffer, Ruth M
dc.contributor.authorFan, Sharon
dc.contributor.authorMullooly, Maeve
dc.contributor.authorFalk, Roni T
dc.contributor.authorJones, Kristine
dc.contributor.authorCaporaso, Neil E
dc.contributor.authorBey-Knight, Lisa
dc.contributor.authorSak, Mark A
dc.contributor.authorSimon, Michael S
dc.contributor.authorGorski, David H
dc.contributor.authorAli, Haythem
dc.contributor.authorLittrup, Peter
dc.contributor.authorDuric, Neb
dc.contributor.authorSherman, Mark E
dc.contributor.authorGierach, Gretchen L
dc.date.accessioned2024-06-27T09:30:27Z
dc.date.available2024-06-27T09:30:27Z
dc.date.issued2023-03-15
dc.identifier.issn2374-4677
dc.identifier.pmid36922547
dc.identifier.doi10.1038/s41523-023-00511-8
dc.identifier.urihttp://hdl.handle.net/10147/641796
dc.descriptionAlthough breast density decline with tamoxifen therapy is associated with greater therapeutic benefit, limited data suggest that endocrine symptoms may also be associated with improved breast cancer outcomes. However, it is unknown whether endocrine symptoms are associated with reductions in breast density after tamoxifen initiation. We evaluated treatment-associated endocrine symptoms and breast density change among 74 women prescribed tamoxifen in a 12-month longitudinal study. Treatment-associated endocrine symptoms and sound speed measures of breast density, assessed via novel whole breast ultrasound tomography (m/s), were ascertained before tamoxifen (T0) and at 1–3 (T1), 4–6 (T2), and 12 months (T3) after initiation. CYP2D6 status was genotyped, and tamoxifen metabolites were measured at T3. Using multivariable linear regression, we estimated mean change in breast density by treatment-associated endocrine symptoms adjusting for age, race, menopausal status, body mass index, and baseline density. Significant breast density declines were observed in women with treatment-associated endocrine symptoms (mean change (95% confidence interval) at T1:−0.26 m/s (−2.17,1.65); T2:−2.12 m/s (−4.02,−0.22); T3:−3.73 m/s (−5.82,−1.63); p-trend = 0.004), but not among women without symptoms (p-trend = 0.18) (p-interaction = 0.02). Similar declines were observed with increasing symptom frequency (p-trends for no symptoms = 0.91; low/moderate symptoms = 0.03; high symptoms = 0.004). Density declines remained among women with detectable tamoxifen metabolites or intermediate/efficient CYP2D6 metabolizer status. Emergent/worsening endocrine symptoms are associated with significant, early declines in breast density after tamoxifen initiation. Further studies are needed to assess whether these observations predict clinical outcomes. If confirmed, endocrine symptoms may be a proxy for tamoxifen response and useful for patients and providers to encourage adherence.en_US
dc.language.isoenen_US
dc.rights© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectBREAST CANCERen_US
dc.subjectCancer epidemiologyen_US
dc.subjectendocrine symptomsen_US
dc.titleShort-term changes in ultrasound tomography measures of breast density and treatment-associated endocrine symptoms after tamoxifen therapy.en_US
dc.typeArticleen_US
dc.identifier.journalNPJ breast canceren_US
dc.source.journaltitleNPJ breast cancer
dc.source.volume9
dc.source.issue1
dc.source.beginpage12
dc.source.endpage
refterms.dateFOA2024-06-27T09:30:29Z
dc.source.countryUnited States


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© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
Except where otherwise noted, this item's license is described as © 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.