The US Preventive Services Task Force has issued final recommendations on the use of medications for reducing the risk of primary breast cancer.

As previously stated in 2013, the USPSTF recommends that clinicians should offer to prescribe risk-reducing medications (ie, tamoxifen, raloxifene, or aromatase inhibitors) to women 35 years or older (without signs or symptoms of breast cancer) who are at increased risk for breast cancer and at low risk for adverse effects associated with these medications (B recommendation). The Task Force also recommends against the use of these agents in women who are not at increased risk for breast cancer (D recommendation).

Based on a review of 10 trials, the USPSTF found that in women at increased risk, over 5 years, the incidence of invasive breast cancer was reduced by 7, 9, and 16 events per 1000 women, with tamoxifen, raloxifene, and aromatase inhibitors, respectively. “For women with a predicted 5-year breast cancer risk of 3% or greater, the absolute benefits are likely even higher,” the Task Force noted. 

However, for women at low risk for breast cancer, the USPSTF found that these agents only provided a small benefit which did not outweigh the potential harms associated with therapy (ie, venous thromboembolic events, vasomotor symptoms, endometrial cancer, cataracts).

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“When considering prescribing risk-reducing medications for breast cancer, clinicians should discuss each woman’s personal values and preferences with respect to breast cancer risk reduction, in addition to what is known about her personal risk for breast cancer and the potential benefits and harms of medications,” concluded the Task Force.

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