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Chemoprevention Strategies 2006

  • Breast Carcinoma
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Several large, prospective trials have evaluated tamoxifen compared with placebo for breast cancer risk reduction in women at increased risk for breast cancer. The risk of developing breast cancer is the primary determinant of net benefit, with greater net benefits accruing to women with the highest risk of breast cancer. Both age and the presence of factors that increase the risk of toxicity have the greatest effect on the net benefit associated with tamoxifen. The greatest clinical benefit with least side effects is derived from the use of tamoxifen in younger, premenopausal women who are less likely to have thromboembolic complications and uterine cancer, in women without a uterus, and in women at higher breast cancer risk such as those with atypical hyperplasia or lobular carcinoma in situ. Tamoxifen may offer benefit to women who are carriers of BRCA2 mutations, although no prospective trials have been conducted. Compared to placebo in postmenopausal women at average risk of breast cancer in published trials of osteoporosis, raloxifene reduces the risk of invasive breast cancer. Among younger postmenopausal women who are at increased risk of breast cancer, raloxifene is as effective as tamoxifen in reducing the risk of invasive breast cancer. Raloxifene appears to be less effective than tamoxifen in reducing the risk of in situ breast cancer. In high-risk, younger, postmenopausal women, raloxifene appears to offer net benefit when comparing reduction of the risk of breast cancer and the prevention of fractures with the risk of stroke, venous thromboembolic events, uterine events, as well as symptomatic side effects.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA

    Victor G. Vogel (MD, MHS)

  2. Magee-Womens Hospital, University of Pittsburgh School of Medicine, 300 Halket Street, Room 3524, Pittsburgh, PA, 15213-3180, USA

    Victor G. Vogel (MD, MHS)

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  1. Victor G. Vogel
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Correspondence to Victor G. Vogel.

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Vogel, V.G. Chemoprevention Strategies 2006. Curr. Treat. Options in Oncol. 8, 74–88 (2007). https://doi.org/10.1007/s11864-007-0019-z

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