In the late 1950s researchers at ICI Pharmaceuticals in the UK were actively looking for a class of anti-oestrogen compounds, hoping to developing a morning-after contraceptive pill. Arthur Walpole and his team synthesised tamoxifen, a drug that has subsequently become the endocrine treatment most widely used in breast cancer, both in adjuvant therapy and for advanced disease. Earlier this week a paper appeared in the Journal of Clinical Oncology showing that if women who are being treated with tamoxifen see a decrease in their breast density, they have a 50% lower risk of dying from breast cancer.
The research team was led by Per Hall at the Karolinska Institutet in Sweden who followed almost a thousand patients over a 15-year period. “To the best of our knowledge, this is the first time mammographic density change has been used as a prognostic marker of response to tamoxifen,” wrote Hall and colleagues. Measuring the change in breast density could therefore be a simple and effective method for assessing whether a drug is working or not.
These findings by the groups in Connecticut and Stockholm, which are supported by a recent paper in Clinical Imaging by Vincenzo and Concetta Giuliano, suggest the need for a screening tool that incorporates both full-field digital mammography and automated breast ultrasound in a single instrument. At CapeRay we are currently building such a device — our dual-modality Aceso model — that will be clinically tested later this year.