Authors' objectives:

This review aims to examine the evidence about the benefits and harms of breast cancer chemoprevention for pre- and postmenopausal women.

Authors' results and conclusions: Strong, direct evidence shows that tamoxifen reduces by approximately half the incidence of invasive and noninvasive breast cancer in pre- and postmenopausal women at high risk for breast cancer. Similarly, evidence from one study suggests that raloxifene reduces by the same amount the incidence of invasive breast cancer in postmenopausal women at low to average risk for breast cancer. Raloxifene also reduces the risk of vertebral fractures in postmenopausal women with osteoporosis. Both drugs are associated with an increased risk of venous thromboembolic disease (deep vein thrombosis and pulmonary embolism); tamoxifen is also associated with an increased risk of endometrial cancer. The balance between benefits and harms varies among subgroups of women, depending on age, predicted risk of breast cancer, and hysterectomy status.

Authors' recommendations: Tamoxifen and raloxifene reduce the incidence of breast cancer in women over a wide range of ages and levels of breast cancer risk. Both drugs may also have other benefits, but they may cause harm in otherwise healthy women who take them for prophylaxis.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/uspstf/uspsbrpv.htm

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)