Chemoprevention of Breast Cancer: A Summary of the Evidence for the U.S. Preventive Services Task Force

  title={Chemoprevention of Breast Cancer: A Summary of the Evidence for the U.S. Preventive Services Task Force},
  author={Linda S. Kinsinger and Russell P. Harris and Steven H. Woolf and Harold C. Sox and Kathleen N. Lohr},
  journal={Annals of Internal Medicine},
Despite improvements in the rates of screening and early detection, treatment advances, and healthier lifestyles, breast cancer remains the most common nonskin cancer among women in the United States. In 2002, it will account for an estimated 203 500 new cases of invasive cancer and 54 300 cases of in situ cancer (1). Although mortality rates for some groups of women have modestly decreased in recent years, 39 600 women are expected to die of breast cancer in 2002 (1-3). The strongest risk… 

Current strategies for the prevention of breast cancer

The objective of this review is to summarize the various approaches directed at reducing the incidence of breast cancer.

Prevention of hormone-related cancers: breast cancer.

  • B. DunnD. WickerhamL. Ford
  • Medicine, Biology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2005
Based on promising data involving reduction of contralateral breast cancer risk in adjuvant studies, several aromatase inhibitors are being incorporated into trials evaluating their efficacy as preventive agents in women at increased risk.

Breast Cancer Chemoprevention – not yet There

In general, the greatest benefit of tamoxifen prevention appears to exist in younger women, hysterectomized women, and women at higher risk, while a meta-analysis of the tamoxIFen studies identified an overall risk reduction of 38% for preventive tamxifen administration.

Breast cancer risk in primary care: implications for chemoprevention.

Small numbers of women in primary care practices are eligible for discussions about chemoprevention; the maximum proportion of breast cancers prevented if eligible women take tamoxifen is also small.

Chemoprevention Strategies 2006

  • V. Vogel
  • Medicine
    Current treatment options in oncology
  • 2007
Tamoxifen may offer benefit to women who are carriers of BRCA2 mutations, although no prospective trials have been conducted and raloxifene appears to offer net benefit when comparing reduction of the risk of breast cancer and the prevention of fractures with therisk of stroke, venous thromboembolic events, uterine events, as well as symptomatic side effects.

Breast Cancer Prevention

Given that the worldwide burden of breast cancer is nearly 1.4 million new cases, a quarter of all cancer diagnoses in women with just under half a million lives lost annually to the disease, the prevention and early detection of Breast cancer remains a major global public health priority.

Lung cancer: genetics of risk and advances in chemoprevention

The authors are poised to learn a great deal about the genetic susceptibility to lung cancer, which will not only allow definition of groups with extremely high risk, but may also yield new insights into processes that determine innate susceptibility or resistance to lung carcinogenesis.

Hormonal interventions to prevent hormonal cancers: breast and prostate cancers

  • B. DunnL. Ford
  • Medicine
    European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation
  • 2007
In an effort to improve its benefit–risk profile, tamoxifen is now being compared with raloxifene, a selective estrogen receptor modulator approved for the treatment and prevention of osteoporosis, which shows efficacy in breast cancer adjuvant trials.

Interest in breast cancer chemoprevention among older women

Breast cancer worry and perceived breast cancer risk contribute to the lack of correlation between interest in breast cancer chemoprevention and objective Breast cancer risk, and aging-related factors such as diminished life expectancy, increased comorbidity, and medication burden do not attenuate chemoparevention interest among older women.

Predicting risk of breast cancer in postmenopausal women by hormone receptor status.

In postmenopausal women, the Gail model identified populations at increased risk for ER-positive but not ER-negative breast cancers, and a model with fewer variables appears to provide a simpler approach for screening for breast cancer risk.



A prospective study of endogenous estrogens and breast cancer in postmenopausal women.

Although estrogen levels appeared to fall within the conventional limits of normality in all women under study, those who subsequently developed breast cancer tended to show higher levels of estrone, total estradiol, and free estradiola, and a lower percent of estradio bound to sex hormone-binding globulin than women who remained free of cancer.

The cost effectiveness of tamoxifen in the prevention of breast cancer.

Assessment of the cost effectiveness of tamoxifen in the prevention of breast cancer in women at increased risk for developing the disease found it may be cost effective, particularly in the 35-to-49 year-old age group and in those of any age who have had a hysterectomy.

Elevated Serum Estradiol and Testosterone Concentrations Are Associated with a High Risk for Breast Cancer

The hypothesis that serum concentrations of estradiol and testosterone, measured an average of 3 years before the clinical diagnosis of breast cancer, are related to risk for breast cancer in women 65 years of age or older is tested.

Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study.

Tamoxifen decreases the incidence of invasive and noninvasive breast cancer and its use as a breast cancer preventive agent is appropriate in many women at increased risk for the disease.

Progesterone and estrogen receptors and mammary neoplasia in the Iowa Women's Health Study: how many kinds of breast cancer are there?

  • J. PotterJ. Cerhan A. Folsom
  • Medicine
    Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
  • 1995
In age- adjusted and polychotomous logistic regression analyses, both ER-PR- and ER+PR- breast cancers showed evidence of an inverted pattern of associations with several risk factors compared with that seen for ER+ PR+ cancers.

Tamoxifen for the prevention of breast cancer

A consensus has existed until recently that using tamoxifen for preventing breast cancer was questionable even in clinical trials, and that only trials in women at high risk of breast cancer could be justified.

Decision analysis of tamoxifen for the prevention of invasive breast cancer.

Tamoxifen use may improve long-term survival and quality-adjusted survival among women who are at increased risk of breast cancer, but this benefit diminishes with age.

RESPONSE: re: Risk/Benefit assessment of tamoxifen to prevent breast cancer-still a work in progress?

Estimates of benefits and risk for the use of tamoxifen for the prevention of breast cancer are proposed, based primarily on the Breast Cancer Prevention Trial (BCPT) data, to construct guidelines to assess the benefits and risks of tamxifen therapy for use in counseling women at risk for breast cancer.

Re: tamoxifen prevention of breast cancer: an instance of the fingerpost

It is unlikely that chemoprevention with tamoxifen will lead to substantial public health benefits, and the calculations by Gail et al. (3) indicate that widespread tamoxIFen use would lead to net public health losses precisely in the very large segment of the general population that contributes the bulk of breast cancer cases.

Weighing the risks and benefits of tamoxifen treatment for preventing breast cancer.

Tamoxifen is most beneficial for younger women with an elevated risk of breast cancer, and the quantitative analyses presented can assist health care providers and women in weighing the risks and benefits of tamoxIFen for reducing breast cancer risk.