Preventing Primary Breast Cancer in Women at Risk

Target Audience: Primary care providers

Background and Objective

This recommendation helps guide clinicians on when to implement a risk-modification strategy for asymptomatic women (age, ≥35). Selective estrogen-receptor modulators (SERMs; tamoxifen and raloxifene [Evista]) lower the incidence of invasive breast cancer by 7 to 9 cases per 1000 women during 5 years. Tamoxifen appears to be more effective and has been approved for women older than 35; raloxifene has been approved for postmenopausal women. Aromatase inhibitors have not been approved by the FDA and were not covered in this recommendation; however, in a recent randomized trial, anastrozole was reported to be more…