Section I: Carcinogenesis
Section II: HRT and breast cancer
5. Breast cancer: epidemiology, pathology and natural history
6. Genes and heredity in breast cancer
7. Endocrine, paracrine and intracrine mechanisms of growth regulation in normal and malignant breast epithelium
8. Chemoprevention of breast cancer with tamoxifen: recent experience and future perspectives
9. Hormonal therapy of breast cancer
10. Hormone replacement therapy and mammographic breast density
11. Hormone replacement therapy, insulin-like growth factor I and breast cancer
12. Postmenopausal hormone use and breast cancer risk: reassessment of the evidence
13. The use of hormonal therapy for management of severe postmenopausal symptoms following breast cancer
Section III: HRT and endometrial cancer
Section IV: HRT and colon cancer
Section V: HRT and melanoma
Section VI: HRT and epithelial ovarian cancer
Section VII: Selective aspects of specific therapies
27. Understanding HRT risks and benefits and the new science of HRT
28. Pulsed estrogen therapy may lead to lower breast stimulation than with daily continuous estrogen exposure
29. Transdermal estrogen therapy and the risk of breast cancer: a clinical appraisal
30. The effects of selective estrogen receptor modulators on the endometrium
31. Safety and tolerability profile of Livial
32. Preclinical and clinical development of new progesterone receptor antagonists with high receptor specificity for breast cancer treatment
33. More than bones: hormone replacement therapy for mind and body
Section I: Carcinogenesis
Section II: HRT and breast cancer
5. Breast cancer: epidemiology, pathology and natural history
6. Genes and heredity in breast cancer
7. Endocrine, paracrine and intracrine mechanisms of growth regulation in normal and malignant breast epithelium
8. Chemoprevention of breast cancer with tamoxifen: recent experience and future perspectives
9. Hormonal therapy of breast cancer
10. Hormone replacement therapy and mammographic breast density
11. Hormone replacement therapy, insulin-like growth factor I and breast cancer
12. Postmenopausal hormone use and breast cancer risk: reassessment of the evidence
13. The use of hormonal therapy for management of severe postmenopausal symptoms following breast cancer
Section III: HRT and endometrial cancer
Section IV: HRT and colon cancer
Section V: HRT and melanoma
Section VI: HRT and epithelial ovarian cancer
Section VII: Selective aspects of specific therapies
27. Understanding HRT risks and benefits and the new science of HRT
28. Pulsed estrogen therapy may lead to lower breast stimulation than with daily continuous estrogen exposure
29. Transdermal estrogen therapy and the risk of breast cancer: a clinical appraisal
Breast cancer – estrogen biosyntheiss and function มีบทบาทสำคัญ
ทั้ง endogenous estrogen production and estrogen therapy(ET)
ทำไม prevalence of CA breast เพิ่มขึ้นในช่วง estogen production ลดลง
relative risk(RR) CA breast 70-74yr 17.0 เมื่อเทียบกับ 30-34yr
ส่วน ET มี RR 1.2-1.4 varies
Estrogen-dependent Breast cancer risk
binding estrogen- ERE – estrogen response element
affinity of estradiol มี distribute ของ α, β estrogen receptor
Estrogen synthesis
ใน postmenopause , estrogen จะถูกสร้งจาก non-ovarian site eg liver , adipose tissue and muscle
ทั้งจำนวนและ type of estrogen ถูกคุมโดย 3 enzyme
– 17β-hydroxylase cytochrome p450 – สร้าง DHEA – dehydroepiandrosterone
– Androstenedione (original จาก cholesterol )
– p450 aromatase – regulate การ conversion androstenedione -> estrone และ testosterone -> estradiol
ส่วน 17βOHSD เป็น bidirectional formation of androstenedione -> testosterone และ estrone -> more potent estradiol
Hydroxylase enzyme and aromatase enzyme ทั้งคู่ ถูก control by cytochrome CYP17 และ CYP19 ตามลำดับ
คนที่มี CYP polymorphism จะมี high serum estradiol
aromatase gene บางสถานะ act เป็น oncogene with breast tissue
17βOHSD level พบว่ามีสูงกว่า normal breast tissue และอาจจะมีผลต่อ progress of disease เมื่อมี elevating local estrogen production
17β-OHSD , aromatase gene
yt Aromatase gene
yt – Aromatase inhibitors
yt – How Long Do Aromatase
30. The effects of selective estrogen receptor modulators on the endometrium
31. Safety and tolerability profile of Livial
32. Preclinical and clinical development of new progesterone receptor antagonists with high receptor specificity for breast cancer treatment
33. More than bones: hormone replacement therapy for mind and body