Open Access<p>Breast Cancer and Tamoxifen: A Nigerian Perspective to Effective Personalised Therapy</p>
Author(s) -
Ayorinde Adehin,
Martin A. Kennedy,
Julius O. Soyinka,
Olusegun Isaac Alatise,
Olalekan Olasehinde,
Oluseye O. Bolaji
Publication year - 2020
Publication title -
breast cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.19
H-Index - 27
ISSN - 1179-1314
DOI - 10.2147/bctt.s266314
Subject(s) - tamoxifen , breast cancer , medicine , oncology , population , estrogen receptor , adjuvant therapy , hormone therapy , context (archaeology) , cancer , gynecology , biology , environmental health , paleontology
Estrogen-receptor positivity in tumour, often requiring long-term tamoxifen therapy, is thought to characterise between 43% and 65% of breast cancer cases in Nigeria. The patient population is further marked by late-stage diagnosis which significantly heightens the tendency for tumour relapse in the course of tamoxifen therapy. Despite tamoxifen being considered a reliable chemopreventive in high-risk individuals and an effective adjuvant therapy for hormone-sensitive tumours, mortality has remained high among breast cancer patients in the West African region where Nigeria belongs. The Nigerian breast cancer population, like other similar patient-populations in the West African region, provides a mix of intrinsic genome-diversity and perhaps unique tumour biology and evolution. These peculiarities suggest the need for a rational approach to tumour management and a personalised delivery of therapy in Nigeria's dominant estrogen-receptor-positive patient population. Herein, critical indices of tamoxifen-therapy success are discussed in the context of the Nigerian breast cancer population with emphasis on salient aspects of tamoxifen-biotransformation, host- and tumour-genomics, and epigenetics.