The Effects Of Zoledronic Acid On Bone Architecture In Premenopausal Women With Breast Cancer Receiving Adjuvant Combined Ovarian Suppression And Aromatase Inhibitor Therapy: A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$122,714.00
Summary
In premenopausal women, a new treatment method that reduces oestrogen levels to almost zero significantly reduces the risk of breast cancer recurrence. However, this is likely to cause substantial bone loss leading to fractures. Using a new imaging technique (HR-pQCT), the effects of profound oestrogen deprivation on bone structure in premenopausal women will be studied. The ability of zoledronic acid, a drug that reduces bone loss, to prevent these adverse bone effects will also be examined.
SOFT And TEXT Premenopausal Randomised Adjuvant Endocrine Breast Cancer Trials.
Funder
National Health and Medical Research Council
Funding Amount
$722,380.00
Summary
SOFT and TEXT trials enrolled premenopausal women with hormone-sensitive early breast cancer to assess if post-operative hormone treatment that included ovarian function suppression plus tamoxifen, or an aromatase inhibitor exemestane, could improve outcomes. Initial results indicate fewer breast cancer recurrences with the treatment combination of ovarian suppression plus exemestane as compared with tamoxifen, and follow-up of women in these trials can show if overall survival can be improved.
An Evaluation Of Bone Density Screening In Premenopausal Women
Funder
National Health and Medical Research Council
Funding Amount
$175,046.00
Summary
Fractures due to osteoporosis are a major public health problem. Bone density is one of the major predictors of these osteoporotic fractures and is the result of the amount of bone gained in early life (i.e peak bone mass) and subsequent bone loss. Cigarette smoking, physical inactivity and inadequate calcium intake are widely regarded as risk factors for osteoporosis (as well as for other common diseases). Despite this information being widely available and actively promoted, the prevalence of ....Fractures due to osteoporosis are a major public health problem. Bone density is one of the major predictors of these osteoporotic fractures and is the result of the amount of bone gained in early life (i.e peak bone mass) and subsequent bone loss. Cigarette smoking, physical inactivity and inadequate calcium intake are widely regarded as risk factors for osteoporosis (as well as for other common diseases). Despite this information being widely available and actively promoted, the prevalence of these risk factors in the population remains unacceptably high suggesting that education alone at the public health level is not sufficient to modify these behaviours. In women (mean age 33) taking part in a study of the determinants of bone mass in children, we recently reported substantial change in these behaviours at 12 months follow-up when women received an information leaflet and individualised bone density information. These women were highly selected and it is unclear if this response is representative of all women. The aims of this study are, therefore, to test hypotheses in a random electoral roll sample of 400 women aged 25-44 from metropolitan Hobart relating to the effect of different types of educational programs and low initial bone mass on both lifestyle changes and changes in bone density over two years. This study will lead to accurate information about how best to target osteoporosis prevention programs in the younger age groups. Furthermore, as risk factors for cardiovascular and other diseases are often similar to those for osteoporosis, it is likely to provide insights into the prevention of these diseases and, as a result, have much greater potential for decreasing disease in the community.Read moreRead less
Cognitive Effects Of Adding Ovarian Function Suppression To Adjuvant Hormonal Therapy In Premenopausal Breast Cancer
Funder
National Health and Medical Research Council
Funding Amount
$301,431.00
Summary
There is mounting evidence that potentially curative treatment for breast cancer might, in some women, have an adverse effect on their subsequent cognitive function i.e. their memory and ability to think clearly. Thus it is important that when new treatments are being tested, the testing includes collecting information on the effect of the new treatment on a woman's cognitive function. There is currently an ongoing large international study examining whether suppressing ovarian function (and thu ....There is mounting evidence that potentially curative treatment for breast cancer might, in some women, have an adverse effect on their subsequent cognitive function i.e. their memory and ability to think clearly. Thus it is important that when new treatments are being tested, the testing includes collecting information on the effect of the new treatment on a woman's cognitive function. There is currently an ongoing large international study examining whether suppressing ovarian function (and thus decreasing oestrogen levels) in women having treatment for breast cancer will improve their outcomes. However,it is known that oestrogen is important for normal cognitive functioning in premenopausal women so there is some concern that dropping the oestrogen levels in this way might cause impairment in cognitive function. In this sub-study we will compare the cognitive function of women having ovarian function suppression with those who do not, to determine if there are any differences. We will also examine how this might affect quality of life.Read moreRead less
What Matters To Women Diagnosed With Breast Cancer During Their Reproductive Years? A Qualitative Investigation Of Fertility, Reproductive Health, Heritability, And Related Psychosocial Needs Using A Population-based Sample
Funder
National Health and Medical Research Council
Funding Amount
$363,158.00
Summary
Breast cancer in women of reproductive age is especially challenging because fertility can be reduced, pregnancy discouraged, and family formation compromised by the illness and its treatment. This research addresses major gaps in knowledge about the needs of young women with breast cancer. Interviews with 100 breast cancer survivors about fertility, family formation, experiences of health care, and ideas about approaches that may assist them will be used to improve fertility-related care.
Tailored Treatments For Premenopausal Patients With Endocrine Responsive Breast Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$257,250.00
Summary
For women under 50 years with hormone receptor positive (ER+) breast cancer, adjuvant treatment with chemotherapy, tamoxifen and ovarian ablation are each effective and reduce recurrence. Combining two treatments is more effective than one, although it is uncertain if combining three provides extra benefit. Ovarian ablation by surgery or radiation is permanent, but reversible ovarian suppression by injections is now available. Three international trials called SOFT, TEXT and PERCHE have been des ....For women under 50 years with hormone receptor positive (ER+) breast cancer, adjuvant treatment with chemotherapy, tamoxifen and ovarian ablation are each effective and reduce recurrence. Combining two treatments is more effective than one, although it is uncertain if combining three provides extra benefit. Ovarian ablation by surgery or radiation is permanent, but reversible ovarian suppression by injections is now available. Three international trials called SOFT, TEXT and PERCHE have been designed for adjuvant therapy of premenopausal women with ER+ breast cancer. These trials take into account regional-country variations in medical practice and different patient choices in this setting. SOFT is for very young women and tests the benefit of adding ovarian suppression in a woman who has received chemotherapy, with tamoxifen planned, but who has not gone into menopause after chemotherapy. The trial also tests if substituting a newer drug called exemestane for tamoxifen, combined with ovarian function suppression is more effective. TEXT is for women who would ordinarily be treated with ovarian suppression plus tamoxifen. The TEXT trial also tests substitution of exemestane for tamoxifen. Exemestane is an aromatase inhibitor. Aromatase inhibitors lower oestrogen levels, but only work if the ovaries are inactive. Recent trials in post menopausal women show aromatase inhibitors are more effective than tamoxifen, and we aim to replicate that improvement in younger women by combining exemestane with ovarian suppression. PERCHE is for women in whom the benefit of chemotherapy is uncertain, for example those with limited or no spread to lymph nodes. All women receive combined endocrine treatment with ovarian suppression plus tamoxifen, and are randomised to receive in addition, either chemotherapy or no chemotherapy, to see if results differ.Read moreRead less
Tailored Treatments For Premenopausal Women With Endocrine Responsive Breast Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$299,213.00
Summary
For women <50yrs with ER+ breast cancer adjuvant treatment (AT) with chemotherapy (CT), tamoxifen and ovarian function suppression (OFS) are each effective and reduce recurrence. Combining 2 treatments is more effective than 1, but it is unclear if combining 3 provides any extra benefit. 2 trials,SOFT and TEXT, aim to answer this question. SOFT tests the benefit of adding OFS for very young women who remain premenopausal after CT, TEXT is for women who should receive OFS from the start of AT.