Tamoxifen and Raloxifene to Prevent Primary Breast Cancer

In 2002, the U.S. Preventive Services Task Force recommended that clinicians discuss risks and benefits of tamoxifen or raloxifene (Evista) therapy for primary prevention of breast cancer with women at high risk (JW Gen Med Jul 19 2002). In this systematic review, authors reevaluated the effectiveness of treatment, the risk for adverse events, and methods for identifying women at high risk.

Seven randomized control trials of good and fair quality were included in the effectiveness and harm analyses. Tamoxifen and raloxifene, compared with placebo, lowered the incidence of invasive breast cancer by 7 to 9 per 1000 women during 5 years of treatment. In a head-to-head comparison (STAR trial; JW Womens Health Jul 13 2006), tamoxifen lowered brea…