Chemoprevention of Breast Cancer: Recommendations and Rationale

  title={Chemoprevention of Breast Cancer: Recommendations and Rationale},
  author={U. S. Preventive Services Task Force},
  journal={Annals of Internal Medicine},
Summary of the Recommendations The U.S. Preventive Services Task Force (USPSTF) recommends against the routine use of tamoxifen or raloxifene for the primary prevention of breast cancer in women at low or average risk for breast cancer (see Clinical Considerations). This is a grade D recommendation (see Appendix Table 1 for a description of the USPSTF classification of recommendations). The USPSTF found fair evidence that tamoxifen and raloxifene may prevent some cases of breast cancer in women… 

Treating Health Risks or Putting Healthy Women at Risk: Controversies around Chemoprevention of Breast Cancer

On April 16, 2006, the National Surgical Adjuvant Breast and Bowel Project (NSABP) of the National Cancer Institute (NCI) called a press conference in order to announce the results of the STAR project, which tested the capacity of tamoxifen to prevent breast cancer against placebo.

Tamoxifen for Breast Cancer Prevention: A Framework for Clinical Decisions

Tamoxifen chemoprevention is cost-effective for women aged 40–50 years who are at significant breast cancer risk, but whether this holds true for older women depends on the initial breast cancerrisk, fear of breast cancer, and presence of the uterus.

Breast Cancer Chemoprevention

Two SERMs, tamoxifen and raloxifene, have been shown to reduce the risk of invasive ER-positive breast cancer by approximately 50% in women at increased risk, and several novel pharmacologic and natural compounds are being considered for future trials.

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.

Primary prevention of breast cancer: whither tamoxifen?

  • D. Rouse
  • Medicine
    Obstetrics and gynecology
  • 2004
An iterative Markov technique is employed to model the net costs and health outcomes of 2 hypothetical cohorts of women and it seems that under all of the conditions modeled, tamoxifen results in an increase in quality-adjusted life years.

Endocrine prevention of breast cancer using selective oestrogen receptor modulators (SORMs).

  • S. LoV. Vogel
  • Medicine, Biology
    Best practice & research. Clinical endocrinology & metabolism
  • 2004

Chemoprevention of Breast Cancer: The Paradox of Evidence versus Advocacy Inaction

Physicians are expected to provide individualized risk assessments to identify high risk women who may be eligible for chemoprevention and it is prudent that physicians utilize a shared decision approach when counseling highrisk women about their preventive options.

Quimioprevención del cáncer de mama

The research of the role of other SERMs (Selective Estrogen Receptor Modulators) and aromatase inhibitors is very active, looking for products having a favorable risk-benefit ratio that will make then useful for wide groups of population.

National surgical adjuvant breast and bowel project update: prevention trials and endocrine therapy of ductal carcinoma in situ.

The proposed NSA BP B-35 trial will have the same design as NSABP B-24 but will compare tamoxifen with anastrozole in postmenopausal women, and outcomes will include both ipsilateral and contralateral new breast cancer and recurrences, as well as the occurrence of regional and distant disease.



Chemoprevention of breast cancer. A joint guideline from the Canadian Task Force on Preventive Health Care and the Canadian Breast Cancer Initiative's Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer.

Overall, current evidence does not support recommending chemoprevention of breast cancer with raloxifene outside of a clinical trial setting, and a shift to its routine use in physicians' offices for screening or case finding is not supported.

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.

American Society of Clinical Oncology technology assessment on breast cancer risk reduction strategies: tamoxifen and raloxifene.

An evidence-based technology assessment to determine whether tamoxifen and raloxifene as breast cancer risk-reduction strategies are appropriate for broad-based conventional use in clinical practice concluded that use of ral oxifene should currently be reserved for its approved indication to prevent bone loss in postmenopausal women.