IGF-I physiology and breast cancer.

Recent studies imply that IGF-I levels vary greatly between normal women, and that premenopausal breast cancer risk is increased among women with higher IGF-I levels. It is known that tamoxifen lowers IGF-I levels, but further research is needed to determine whether antiestrogens will be of particular value in risk reduction for women with high IGF-I levels, and also to determine if IGF-I levels can indeed be used as an intermediate endpoint in risk reduction interventions. With respect to adjuvant therapy, we currently have convincing data that antiestrogens have moderate IGF-I lowering actions, but it remains unclear to what extent these contribute to the therapeutic effect of these compounds. Ongoing trials are addressing this question, as well as the hypothesis that interventions that increase IGF-I suppression will be associated with reduced relapse rates.