2012 EDUCATIONAL BOOK - American Society of Clinical Oncology

CHEMOPREVENTION FOR BREAST CANCER
Conclusion
Breast cancer is the most common malignancy among
women in the United States affecting approximately
225,000 women annually. Evidence from randomized,
placebo-controlled clinical trials supports the use of chemoprevention
for reducing the risk of primary invasive breast
cancer, and there are three options: tamoxifen, raloxifene,
and exemestane. Risk–benefit models indicate that raloxifene
results in a better risk–benefit profile for black, Hispanic,
and non-Hispanic white postmenopausal women with
a uterus when compared with tamoxifen. Similar benefits
for postmenopausal black and non-Hispanic white women
without a uterus are seen for tamoxifen and raloxifene. Only
a small portion of women who are eligible for chemopreven-
Authors’ Disclosures of Potential Conflicts of Interest
Employment or
Leadership
Positions
Consultant or
Advisory Role
Author
Abenaa M. Brewster*
Nancy E. Davidson GlaxoSmithKline
(U)
Worta McCaskill-Stevens*
*No relevant relationships to disclose.
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tion receive treatment, and the barriers to uptake include
lack of education about breast cancer, inadequate physician
training in risk assessment, lack of time to provide counseling,
concerns about side effects, cost, and misconceptions
about actual and perceived risks and benefits of treatment.
Strategies to close this gap have focused on educating
women about breast cancer and their competing health risks
as well as developing easily accessible decision aids and risk
assessment models that accurately convey the risks and
benefits of chemoprevention treatment. An active area of
research is the identification of biomarkers and clinical
features to improve the selection of women most likely to
benefit from chemoprevention and to predict and monitor
responsiveness of treatment.
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Ownership Honoraria
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