Breast CancerHormone therapy

1Brian Lin

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Cancer and Estrogen

Breast Cancer Treatment

Hormone therapy

Premenopausal treatment

Postmenopausal treatment

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Cancer Arises From DNA Mutations in Cells

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Cancer Arises From DNA Mutations in Cells

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Estrogen Effect

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Beneficial effects

Breast

Programs milk production

Liver and heart

Controls cholesterol

Uterus

Prepares for fetus

Bone

Preserves strength

Harmful effects

Breast

Increases cancer risk

Uterus

Increases cancer risk

Estrogen Effect

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Beneficial effects

Breast

Programs milk production

Liver and heart

Controls cholesterol

Uterus

Prepares for fetus

Bone

Preserves strength

Harmful effects

Breast

Increases cancer risk

Uterus

Increases cancer risk

Beneficialeffects

Harmfuleffects

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Hypothalamus(下視丘)

Gonadotropins (促性腺激素)-FSH (濾泡刺激素)-LH (黃體生成素)

Ovary(卵巢)

Estrogens (雌激素) Progesterone (黃體激素)

Prolactin

Growth Hormone

Pituitary gland

Adrenal gland(腎上腺)

Progesterone(黃體激素)

Androgens (雄性素)Estrogens(雌激素)

Corticosteroids(皮質固醇)

Premenopausal

Adrenocorticotropichormone (ACTH：促腎上腺皮質素)

Estrogen production

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Hypothalamus(下視丘)

Gonadotropins (促性腺激素)-FSH (濾泡刺激素)-LH (黃體生成素)

Ovary(卵巢)

Estrogens (雌激素) Progesterone (黃體激素)

Prolactin

Growth Hormone

Pituitary gland

Adrenal gland(腎上腺)

Progesterone(黃體激素)

Androgens (雄性素)Estrogens(雌激素)

Corticosteroids(皮質固醇)

Premenopausal

Adrenocorticotropichormone (ACTH：促腎上腺皮質素)

Estrogen production

Estrogen-Induced Proliferation andSpontaneous New Mutations

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Estrogen stimulation

Normal breast cell

Mistake in DNA duplication

Increased proliferation

Cancer and Estrogen

Breast Cancer Treatment

Hormone therapy

Premenopausal treatment

Postmenopausal treatment

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Surgery

Surgery Chemotherapy

Surgery

Radiation therapy

Chemotherapy

Surgery

Radiation therapy

Chemotherapy

Hormone therapy

Surgery

Radiation therapy

Chemotherapy

Hormone therapy

Tageted therapy

Cancer and Estrogen

Breast Cancer Treatment

Hormone therapy

Premenopausal treatment

Postmenopausal treatment

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• 補充女性荷爾蒙

• 減少停經症候群發生Postmenopausal

• 使用抗荷爾蒙藥物

• 減少乳癌復發

Early Stage Breast Cancer

• 使用抗荷爾蒙藥物

• 延緩乳癌疾病的惡化

Metastatic Breast Cancer

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60-66%

ER+ or PR+

21-25%

HER2+

13-15%

ER-/PR/HER2-

可用賀爾蒙療法

可用標靶治療

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Estrogen receptor antagonist 抗雌性激素

• 與雌性激素競爭受體，以阻斷雌性激素作用

• Tamoxifen

Aromatase Inhibitor 芳香環轉化酵素抑制劑

• 阻斷雌性激素的生成

• Anastrozole, Letrozole, Exemestane

GnRH agonist 類性腺激素釋放素

• 促黃體激素釋放荷爾蒙致效劑(LH-RH致效劑)

• Goserelin (Zoladex)

Cancer and Estrogen

Breast Cancer Treatment

Hormone therapy

Premenopausal treatment

Postmenopausal treatment

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Estrogen(雌性激素)

FSH, LH(促雌性素)

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Tamoxifen

Zoladex

Estrogen(雌性激素)

FSH, LH(促雌性素)

Hormonal Therapy - Tamoxifen

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Estrogen

Progestrone

Tamoxifen

Hormonal Therapy - Tamoxifen

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Estrogen

Progestrone

Tamoxifen

Cancer and Estrogen

Breast Cancer Treatment

Hormone therapy

Premenopausal treatment

Postmenopausal treatment

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Adrenal gland(腎上腺)

Androgens(雄性素)

Aromatase芳香環轉化酶

Estrogen(雌性激素)

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Adrenal gland(腎上腺)

Androgens(雄性素)

Aromatase芳香環轉化酶

Estrogen(雌性激素)

Aromatase Inhibitor

Tamoxifen

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乳癌診斷及治療請洽專科醫師