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July 2009 · Vol. 21, No. 07

The case for chemoprevention as a tool to avert breast cancer

Women at high risk of invasive breast cancer can elect chemoprevention with tamoxifen or raloxifene. An aromatase inhibitor may one day be an option.


Fast Track

A Gail-model 5-year estimate of 1.66% or higher denotes a high risk of breast cancer

In the Breast Cancer Prevention Trial, tamoxifen reduced the risk of invasive breast cancer by 49% and the risk of noninvasive cancer by 50%

With tamoxifen, serious adverse events do not occur at the same magnitude in women younger than 50 years that they do in women 50 and older

Raloxifene does not cause endometrial hyperplasia or cancer and is not associated with vaginal bleeding or increased endometrial thickness

Both raloxifene and tamoxifen have consistently been associated with a twofold to threefold increase in the risk of thromboembolic events, compared with placebo

IN THIS ARTICLE

Steven  R.  Goldstein,  MD

Dr. Goldstein is Professor of Obstetrics and Gynecology at New York University School of Medicine and Director of Gynecologic Ultrasound and Co-Director of Bone Densitometry at NYU Medical Center in New York City. He serves on the OBG Management Board of Editors.

The author reports that he is a consultant to Eli Lilly, Pfizer, and Wyeth, and a speaker for Eli Lilly and Wyeth.

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