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Thursday, 28 September, 2000, 14:02 GMT 15:02 UK
'Vitamin A' drug hope for breast cancer
vitamins on shelf
Vitamin derivatives hold out hope for women
A drug derived from vitamin A could prevent development of breast cancer in young women.

Use of the vitamin A compound, fenretinide, protects younger women in the early stages of the disease from developing a second tumour.

Now scientists believe that fenretinide could be used in those women at high risk of developing breast cancer to stop them developing it in the first place.

A trial in Italy of 3,000 women with stage one breast cancer found that young women treated with fenretinide after surgery were much less likely to suffer recurrence in the affected breast or to develop a tumour in the other breast than those who did not take the drug.

Dr Alberto Costa from the European Institute of Ocology Breast Division in Milan told a conference in Brussels that "not only could we have an effective treatment for patients but also a potential preventative drug for healthy women at high risk".

But, while premenoapusal women have been shown to clearly benefit from taking fenretinide, the effect is reversed in women after the menopause.

In younger women in the Italian study there were 27 second cancers in the healthy breast among those taking the drug compared with 42 who were untreated;and 58 cancers in the previously affected breast in the treated group compared with 87 in the control group.

Conversely, in postmenopausal women the number of second cancers was slightly higher among those taking finretinide over the eight years in which the women were followed.

The scientists conclude that the drug interacts with oestrogen in the body to have a protective effect against breast cancer.

Dr Costa believes more trials into use of fenretinide are vital and two further studies are already underway, one in combination with low dose tamoxifen in high risk premenopausal women and one in conjunction with hormone replacement therapy (HRT) in postmenopausal women.

However, caution will be necessary in young women as high doses of vitamin A have already been linked to foetal abnormalities.

Delyth Morgan chief executive of Breakthrough Breast Cancer supported the call for further research.

"It is important that we invest in finding treatments for breast cancer that have fewer side-effects.

"This is interesting research but we need to see more trials to make sure the positive effects are repeatable and able to be sustained," she said.

Preventive tamoxifen five years away

Meanwhile, in the UK doctors believe it will be five years before they are sure whether tamoxifen can be given to women as a preventive drug.

This is despite the fact that, in the US, the drug and others like it are already widely used this way.

European experts have so far been far more cautious about recommending that the drugs be licenced for prevention of breast cancer, particularly as they do produce marked side-effects in many women.

Professor Trevor Powles, from the Royal Marsden Hospital in Surrey, said: "The general opinion of cancer specialists in Europe is that it is not possible to identify any risk groups of healthy women in whom use of tamoxifen or raloxifene is justified at this time outside of clinical trials."

The drug would potentially be offered to women considered to be at the highest risk of developing the disease, such as those with a strong family history of breast cancer.

At the moment, all these women can be offered is frequent check-ups and screening, and in the most extreme cases, the removal of both healthy breasts to prevent the disease developing.

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See also:

28 Sep 00 | Health
Breast Cancer 2000
12 Apr 00 | Health
Breast cancer 'may be blocked'
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Breast cancer deaths plummet
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Breast Cancer
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