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Task Force Issues Final Recommendation Statement on Medications for Risk Reduction of Primary Breast Cancer

Amoxifen and raloxifene may have serious side effects (September 24)

The U.S. Preventive Services Task Force (USPSTF) has released its final recommendation statement on medications for risk reduction of primary breast cancer in women. The task force recommends that clinicians engage in shared, informed decision-making with women who are at increased risk for breast cancer about medications to reduce their risk. For women who are not at an increased risk for breast cancer, the task force recommends against the use of these medications.

Evidence shows that, for women at high risk for developing breast cancer, certain medications — specifically, tamoxifen and raloxifene — may reduce the risk. Women most at risk for getting breast cancer because of family history or other risk factors should weigh the benefits and harms of risk-reducing medications with their doctor.

Tamoxifen and raloxifene are part of a class of drugs that block the effects of estrogen in breast tissue. Some studies have shown that they reduce the risk of estrogen receptor (ER)-positive breast cancer, a type of cancer that is sensitive to estrogen. While these medications can reduce a woman’s risk for developing breast cancer, they have the potential to cause serious adverse effects, including blood clots, an increased risk for endometrial cancer, and cataracts.

The task force’s final recommendation applies to women 35 years old and older who do not have signs or symptoms of breast cancer and who have never been diagnosed with breast cancer, DCIS (abnormal cells in the milk glands or ducts that indicate an increased risk for breast cancer), or LCIS (abnormal cells in the lobules of milk glands in the breast that indicate an increased risk for breast cancer). In addition, the recommendation does not apply to women with a history of blood clots, including deep-vein thrombosis, blood clots in the lung, strokes, or mini-strokes.

The final recommendation statement was published online in the Annals of Internal Medicine and is available on the USPSTF Web site.

Source: USPSTF; September 24, 2013.

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