Chemoprevention of Breast Cancer: Recommendations and Rationale

@article{Force2002ChemopreventionOB,
  title={Chemoprevention of Breast Cancer: Recommendations and Rationale},
  author={U. S. Preventive Services Task Force},
  journal={Annals of Internal Medicine},
  year={2002},
  volume={137},
  pages={56-58}
}
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

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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.

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TLDR
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.

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TLDR
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TLDR
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.
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References

SHOWING 1-3 OF 3 REFERENCES

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.

TLDR
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.

TLDR
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.

TLDR
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.