Tamoxifen Prevents Premalignant Changes of Breast, but not Ovarian, Cancer in Rats at High Risk for Both Diseases

Women at increased risk for breast cancer are at increased risk for ovarian cancer as well, reflecting common risk factors and intertwined etiology of the two diseases. We previously developed a rat model of elevated breast and ovarian cancer risk, allowing evaluation of dual-target cancer prevention strategies. Tamoxifen, a Food and Drug Administration–approved breast cancer chemoprevention drug, has been shown to promote ovarian cysts in premenopausal women; however, the effect of tamoxifen on ovarian cancer risk is still controversial. In the current experiment, Fischer 344 rats (n = 8 per treatment group) received tamoxifen (TAM) or vehicle (control) in factorial combination with combined breast and ovarian carcinogen (17β-estradiol and 7,12 dimethylbenza[a]anthracene, respectively). Mammary and ovarian morphologies were normal in the control and TAM groups. Carcinogen (CARC) treatment induced mammary dysplasia with elevated cell proliferation and reduced estrogen receptor-α expression and promoted preneoplastic changes in the ovary. In the CARC + TAM group, tamoxifen reduced preneoplastic changes and proliferation rate in the mammary gland, but not in the ovary, compared with rats treated with carcinogen alone. Putative stem cell markers (Oct-4 and aldehyde dehydrogenase 1) were also elevated in the mammary tissue by carcinogen and this expansion of the stem cell population was not reversed by tamoxifen. Our study suggests that tamoxifen prevents early progression to mammary cancer but has no effect on ovarian cancer progression in this rat model.

[1]  R. Rawal,et al.  Decline in breast cancer incidence after decrease in utilisation of hormone replacement therapy , 2008, Breast Cancer Research and Treatment.

[2]  D. Birnbaum,et al.  ALDH1 is a marker of normal and malignant human mammary stem cells and a predictor of poor clinical outcome. , 2007, Cell stem cell.

[3]  G. Buchanan,et al.  Disruption of androgen receptor signaling by synthetic progestins may increase risk of developing breast cancer , 2007, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[4]  K. Noller,et al.  Correlation of umbilical cord blood hormones and growth factors with stem cell potential: implications for the prenatal origin of breast cancer hypothesis , 2007, Breast Cancer Research.

[5]  L. Miele,et al.  Cancer stem cells – an old idea that’s new again: implications for the diagnosis and treatment of breast cancer , 2007, Expert opinion on biological therapy.

[6]  M. Mayo,et al.  Reduction in proliferation with six months of letrozole in women on hormone replacement therapy , 2007, Breast Cancer Research and Treatment.

[7]  A. Ashworth,et al.  Dissociation of estrogen receptor expression and in vivo stem cell activity in the mammary gland , 2007, The Journal of cell biology.

[8]  G. Colditz,et al.  A prospective study of postmenopausal hormone use and ovarian cancer risk , 2006, British Journal of Cancer.

[9]  L. Hilakivi-Clarke,et al.  Timing of Dietary Estrogenic Exposures and Breast Cancer Risk , 2006, Annals of the New York Academy of Sciences.

[10]  P. Hartge,et al.  Menopausal hormone therapy and ovarian cancer risk in the National Institutes of Health-AARP Diet and Health Study Cohort. , 2006, Journal of the National Cancer Institute.

[11]  M. Wicha Identification of murine mammary stem cells: implications for studies of mammary development and carcinogenesis , 2006, Breast Cancer Research.

[12]  B. Fauser,et al.  What role of estrogens in ovarian stimulation. , 2006, Maturitas.

[13]  Norman Wolmark,et al.  Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. , 2006, JAMA.

[14]  G. Mills,et al.  Progress in Chemoprevention Drug Development: The Promise of Molecular Biomarkers for Prevention of Intraepithelial Neoplasia and Cancer—A Plan to Move Forward , 2006, Clinical Cancer Research.

[15]  B. Macmahon Epidemiology and the causes of breast cancer , 2006, International journal of cancer.

[16]  T. Jacks,et al.  Cyclooxygenase-1 is overexpressed in multiple genetically engineered mouse models of epithelial ovarian cancer. , 2006, Cancer research.

[17]  P. Chambon,et al.  Paracrine signaling through the epithelial estrogen receptor α is required for proliferation and morphogenesis in the mammary gland , 2006, Proceedings of the National Academy of Sciences of the United States of America.

[18]  S. Aslan,et al.  Ovarian cyst formation in patients using tamoxifen for breast cancer. , 2005, Japanese journal of clinical oncology.

[19]  R. Humphries,et al.  Activation of Stem‐Cell Specific Genes by HOXA9 and HOXA10 Homeodomain Proteins in CD34+ Human Cord Blood Cells , 2005, Stem cells.

[20]  V. Steele,et al.  Characterization of rat ovarian adenocarcinomas developed in response to direct instillation of 7,12-dimethylbenz[a]anthracene (DMBA) coated suture. , 2005, Carcinogenesis.

[21]  Christos Patriotis,et al.  Characterization of a Carcinogenesis Rat Model of Ovarian Preneoplasia and Neoplasia , 2004, Cancer Research.

[22]  L. Olson,et al.  Oct4 expression in adult human stem cells: evidence in support of the stem cell theory of carcinogenesis. , 2004, Carcinogenesis.

[23]  P. Post,et al.  Review of epidemiological evidence for reproductive and hormonal factors in relation to the risk of epithelial ovarian malignancies , 2004, Acta obstetricia et gynecologica Scandinavica.

[24]  M. Terplan,et al.  Comparison of tamoxifen and clomiphene citrate for ovulation induction: a meta-analysis. , 2004, Human reproduction.

[25]  M. Mayo,et al.  Breast Cancer Chemoprevention Phase I Evaluation of Biomarker Modulation by Arzoxifene, a Third Generation Selective Estrogen Receptor Modulator , 2004, Clinical Cancer Research.

[26]  A. Luini,et al.  A randomized trial of low-dose tamoxifen on breast cancer proliferation and blood estrogenic biomarkers. , 2003, Journal of the National Cancer Institute.

[27]  C. Brekelmans Risk factors and risk reduction of breast and ovarian cancer , 2003, Current opinion in obstetrics & gynecology.

[28]  O. Tawfik,et al.  Prevention of solely estrogen-induced mammary tumors in female aci rats by tamoxifen: evidence for estrogen receptor mediation. , 2002, The Journal of endocrinology.

[29]  L. Mariani,et al.  Effect of fenretinide on ovarian carcinoma occurrence. , 2002, Gynecologic oncology.

[30]  O. Tawfik,et al.  Ploidy differences between hormone‐ and chemical carcinogen–induced rat mammary neoplasms: Comparison to invasive human ductal breast cancer * , 2002, Molecular carcinogenesis.

[31]  V. Vogel,et al.  Reducing the risk of breast cancer with tamoxifen in women at increased risk. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[32]  P. Lapolt,et al.  Influences of Age and Ovarian Follicular Reserve on Estrous Cycle Patterns, Ovulation, and Hormone Secretion in the Long-Evans Rat1 , 2001, Biology of reproduction.

[33]  Meenakshi Singh,et al.  Rat Models of Premalignant Breast Disease , 2000, Journal of Mammary Gland Biology and Neoplasia.

[34]  M. Mayo,et al.  Short-term breast cancer prediction by random periareolar fine-needle aspiration cytology and the Gail risk model. , 2000, Journal of the National Cancer Institute.

[35]  M. Sporn,et al.  Randomized trial of fenretinide to prevent second breast malignancy in women with early breast cancer. , 1999, Journal of the National Cancer Institute.

[36]  C K Redmond,et al.  Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. , 1999, Journal of the National Cancer Institute.

[37]  R. Clarke,et al.  Epithelial stem cells in the mammary gland: casting light into dark corners , 1999, Breast Cancer Research.

[38]  H. Risch Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone. , 1999, Journal of the National Cancer Institute.

[39]  B. O’Malley,et al.  Proteasome-dependent degradation of the human estrogen receptor. , 1999, Proceedings of the National Academy of Sciences of the United States of America.

[40]  A. Figer,et al.  Ovarian overstimulation and cystic formation in premenopausal tamoxifen exposure: comparison between tamoxifen-treated and nontreated breast cancer patients. , 1999, Gynecologic oncology.

[41]  M. Cotterchio,et al.  Surgical procedures associated with risk of ovarian cancer. , 1997, International journal of epidemiology.

[42]  A. Malpica,et al.  Ovarian intraepithelial neoplasia and ovarian cancer. , 1996, Obstetrics and gynecology clinics of North America.

[43]  M. Pike,et al.  Ovarian cancer and long-term tamoxifen in premenopausal women , 1991, The Lancet.

[44]  G. S. Greenwald,et al.  The long-term effects of unilateral ovariectomy of the cycling hamster and rat. , 1972, Biology of reproduction.

[45]  B. Kimler,et al.  Characterization of a preclinical model of simultaneous breast and ovarian cancer progression. , 2007, Carcinogenesis.

[46]  D. Proia,et al.  Reconstruction of human mammary tissues in a mouse model , 2006, Nature Protocols.

[47]  J. Russo,et al.  The concept of stem cell in the mammary gland and its implication in morphogenesis, cancer and prevention. , 2006, Frontiers in bioscience : a journal and virtual library.

[48]  M. Morita,et al.  Tissue-distribution of aldehyde dehydrogenase 2 and effects of the ALDH2 gene-disruption on the expression of enzymes involved in alcohol metabolism. , 2005, Frontiers in bioscience : a journal and virtual library.

[49]  G. Cheng Inaugural Article: Estrogen receptors ER and ER in proliferation in the rodent mammary gland , 2004 .

[50]  T. Powles COMMENT ON: TAMOXIFEN FOR PREVENTION OF BREAST CANCER : REPORT OF THE NATIONAL SURGICAL ADJUVANT BREAST AND BOWEL PROJECT P-1 STUDY , 1999 .