Is chemoprevention practical?
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- Fabian, C.J. & Kimler, B.F. Curr Breast Cancer Rep (2009) 1: 48. doi:10.1007/s12609-009-0007-3
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Breast cancer chemoprevention is practical only if 1) it reduces the incidence of cancer and overall mortality in a cost-effective manner, and 2) an easily identified target population is willing to undergo treatment. In the past decade, it was demonstrated that breast cancer risk reduction is possible with tamoxifen and raloxifene and is cost effective on the higher end of the risk continuum. However, uptake has not been optimal due to concerns of side effects, incomplete efficacy, and uncertainty regarding who is most likely to benefit. For prevention to be considered effective and practical, we need to develop 1) more accurate methods of risk assessment; 2) prevention interventions with fewer side effects and/or greater efficacy; and 3) effective means of motivating uptake of behavioral and drug prevention therapy.