High-risk women

The IBIS-I study was promoted by the UK Coordinating Committee for Cancer Research and supported by the Imperial Cancer Research Fund. A group of 7152 high-risk women were selected according to criteria related to familial cases of breast cancer, previous atypical biopsies, and parity. The most important group was that of women with two or more first- or second-degree relatives with breast cancer. For this group the yearly frequency of breast cancer, in the absence of any intervention, was calculated to be 7.50 per 1000 women. This proved to be accurate since the actual frequency in the placebo... 

Veronesi U, Maisonneuve P, Rotmenz N et al. (2002b) Italian randomised trial among women with hysterectomy tamoxifen and hormone dependent breast cancer in high-risk women. J Natl Cancer Inst 94 160-165... 

Prevention of Breast cancer in high-risk women PO 20 mg/day... 

Contraindications Concomitant coumarin-type therapy when used in the treatment of breast cancer in high-risk women, history of deep vein thrombosis or pulmonary embolism in high-risk women... 

In a breast cancer prevention study in high-risk women, treatment with a daily dose of 20 mg of tamoxifen for a median duration of 55 months decreased the risk of invasive breast cancer by 49% and the risk of ER-positive breast cancer by 69% (Fisher et al., 1998). However, in... 

Ovarian cancer is asymptomatic in its early stages and usually goes undetected until well advanced and difficult to treat. Screening for ovarian cancer has not yet been shown to be effective, partly for want of a preoperative technique to confirm or exclude malignancy in suspicious lesions that are identified by the screening process. In vivo MRS may offer such a method by early confirmation of ovarian cancers in high-risk women (i.e. with a family history of the disease) in whom screening would be warranted. 

Aims of voucher scheme Increase the uptake of screening among poor and high-risk women, improve quality of cervical cytology, ensure follow-up and effective treatment of precancerous lesions. 

Recently, there have been efforts to correlate depurinating estrogen DNA adducts with breast cancer risk. Ratios of depurinating DNA adducts to their respective estrogen metabolites were significantly higher in high-risk women (12... 

Only two classic indications for breast MRI do not appear, a priori, to be good indications for the CEDM. They are screening of high-risk women (BRCAl/2) because of their sensitivity to radiation exposure and the assessment of response to neoadjuvant chemotherapy because several imaging examinations are needed and will best be performed using a nonradiating imaging method. 

After 7.3 years of treatment and follow-up, a combination pill of folic acid (2.5 mg), vitamin Bg (50 mg) and vitamin B (1 mg) did not reduce a combined end-point of total cardiovascular events among high-risk women, despite significant homocysteine lowering. 

A recent study evaluated whether a combination of folic acid, vitamin Bg and vitamin B12 lowers risk of CVD among high-risk women with and without CVD. A total of 5442 women who were US health professionals aged 42 years or older, with either a history of CVD or three or more coronary risk factors, were enrolled in a randomized, double-blind, placebo-controlled trial to receive... 

In general, women of childbearing potential are encouraged to take 0.4 mg of folic acid per day, with the dose increased to 4 mg per day for high-risk women. The recommendation of 0.4 mg folic acid per day applies to most fertile women on AEDs. Four mg per day is recommended for women on inducer AEDs and VPA. However, there is sparse evidence that favour high doses of folic acid. Some reports suggest that supplementation with low-dose folic acid i.e. <0.4 mg) may be sufficient for normalizing homocysteine metabolism in epilepsy (Apeland et al. 2002). 

NCT00917735 Phase II, randomized, double-blind, placebo-controlled study of the efficacy of green tea extract on biomarkers of breast cancer risk in high-risk women with differing catechol-O-methyltransferase (COMT) genotypes... 

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