Hormonal Regulation of Endocrine-resistant Breast Cancer (Pehmeäkantinen kirja)

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Breast cancer is the most common type of cancer among women in western world. In Finnish women, approximately 4000 - 5000 new breast cancers are diagnosed every year. Approximately 70 percent of breast cancers express estrogen receptor (ER). These tumors use estrogen as their main growth stimulus and they are considered to be hormone-dependent. Endocrine therapy targeting ER is the most effective treatment of hormone-dependent breast cancer therapy both in the adjuvant and metastatic setting.

In premenopausal women, the main source of estrogen is the ovaries, while in postmenopausal women, the enzyme aromatase converts estrogen from androgens in peripheral tissues such as adipose, skin or bone. In hormone-dependent breast cancer, the suppression of tumor growth can be achieved by reducing estrogen levels with chemical ovarian ablation (occasionally with surgery or radiation) in premenopausal women, or with aromatase inhibitors in postmenopausal women. Also, the interaction of estrogen and ER can be blocked by using selective ER modulators (SERMs) or by downregulating the expression of ER with selective ER downregulators (SERDs) both in premenopausal and postmenopausal women.
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