Methods of reducing mammographic breast density and/or breast cancer risk

1. A method of reducing mammographic breast density and/or breast stiffness in a patient, comprising administering to the patient:

i) an effective amount of a selective androgen receptor modulator selected from the group consisting of:

(2S)-3-(4-cyanophenoxy)-N-[4-cyano-3-(trifluoromethyl)phenyl]-2-hydroxy-2-methylpropanamide;

(7R,7aS)-2-Chloro-4-(7-hydroxy-1,3-dioxotetrahydropyrrolo[1,2-c]imidazol-2-yl)-3-methylbenzonitrile;

4-((R)-2-((R)-2,2,2-trifluoro-1-hydroxyethyl)pyrrolidin-1-yl)-2-trifluoromethyl)benzonitrile;

4-(3-Hydroxy-8-aza-bicyclo[3.2.1]octyl)-naphthalene-1-carbonitrile;

JNJ-28330835;

6-(bis-(2,2,2-trifluoroethyl)amino)-4-trifluoromethyl-1H-quinolin-2-one;

9-chloro-2-ethyl-1-methyl-3-(2,2,2-trifluoroethyl)-3H-pyrrolo[3,2-f]quinolin-7(6H)-one;

2-[4-(dimethylamino)-6-nitro-1,2,3,4-tetrahydroquinolin-2-yl]-2-methylpropan-1-ol; and

(2S)—N-(4-cyano-3-trifluoromethylphenyl)-3-(3-fluoro-4-chlorophenoxy)-2-hydroxy-2-methyl-propanamide;

or pharmaceutically acceptable salts thereof; and

ii) an effective amount of an aromatase inhibitor selected from the group consisting of: exemestane, formestane, anastrozole, letrozole, vorozole, and fadrozole.

2. The method of claim 1 , wherein the patient has, or is diagnosed with having, a breast with:

i) a mammographic breast density of 7.5% or greater;

ii) an area breast density percentage (ABD %) of 7.5% or greater;

iii) a volume breast density percentage (VBD %) of 7.5% or greater; and/or

iv) a BIRADS score of 3 or 4 (or c or d).

3. The method of claim 1 , wherein the patient is premenopausal, peri-menopausal, or post-menopausal.

4. The method of claim 1 , wherein:

i) the reduction in mammographic breast density is in the range of between 5% to 25% or 10% to 25% after 1 year, 2 years, 3 years, 4 years or 5 years of treatment;

ii) the method reduces the VBD % or absolute volume breast density (AVBD) of the patient's breast between one or more annual intervening mammographic detections; and/or

iii) the method reduces the ABD % or absolute area breast density (AABD) of the patient's breast between one or more annual intervening mammographic detections.

5. The method of claim 1 , wherein the breast stiffness reduces by at least 10% after 1 year, 2 years, 3 years, 4 years or 5 years of treatment.

6. The method of claim 1 , wherein the method increases or improves the patient's fat to breast tissue ratio from 1:19 to 19:1 over a 3 month period, over a 6 month period, over a 9 month period, over a 1 year period, or over a 5 year period.

7. The method of claim 1 , wherein the method reduces the treated patient's risk of developing breast cancer between one or more annual intervening mammographic detections.

8. The method of claim 1 , wherein the method provides one or more of the following:

i) enhances mammographic detection due to reduced breast density enabling the mammogram to visualize malignancy at an earlier and/or less aggressive stage;

ii) enhances the ability to achieve better mammographic compression due at least in part due to reduced pain;

iii) enhances the ability to achieve better patient compliance in having regular mammographic check-ups;

iv) enhances the ability to treat the patient and at the same time not causing perturbations in the hypothalamic-pituitary axis and/or other endocrine axis;

v) reduces breast pain in a patient;

vi) reduces breast elasticity in a patient;

vii) decrease mechano-transduction on the genome of a cell in order to reduce the risk of malignant transformation in a patient;

viii) increases ratio of fibro-glandular and adipose tissue in a patient;

ix) increases CD36 in a patient;

x) stabilizes and/or an increase in levels of androgen receptor expression in breast tissue of a patient;

xi) increases the level of GCDFP15 in a patient;

xii) reduces BPE in an MRI breast image of a patient;

xiii) improves detection of breast abnormalities due to reduced BPE in an MRI breast image of a patient; and

xiv) reduces cysts in size and/or quantity in a patient's breast.

9. The method of claim 1 , wherein the method reduces or reverses peri-menopausal symptoms.

10. The method of claim 1 , wherein the selective androgen receptor modulator is (2S)-3-(4-cyanophenoxy)-N-[4-cyano-3-(trifluoromethyl)phenyl]-2-hydroxy-2-methylpropanamide.

11. The method of claim 1 , wherein the aromatase inhibitor is anastrozole.