USPSTF Recommendations on Breast Cancer Risk-Reducing Drugs

The U.S. Preventive Services Task Force (USPSTF) published its final recommendation statement on medications for risk reduction of primary breast cancer in women.

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The Task Force recommends:

• For women who are at increased risk, clinicians should engage in shared, informed decision-making about medications to reduce their risk
• For women who are not at increased risk, the use of these medications is not recommended

Certain medications, specifically tamoxifen and raloxifene, have been shown to possibly reduce the risk for women at high risk for developing breast cancer. 

Tamoxifen and raloxifene (Evista; Eli Lilly) are selective estrogen receptor modulators that have demonstrated risk reduction of estrogen receptor (ER)-positive breast cancer in postmenopausal women in randomized, controlled trials.

A systematic review found that tamoxifen and raloxifene reduced the incidence of invasive breast cancer by 7–9 events per 1000 women over 5 years and that tamoxifen reduced breast cancer incidence more than raloxifene. 

Tamoxifen was also found to reduce the incidence of invasive breast cancer in premenopausal women who are at increased risk for the disease.

The Task Force recommendation applies to women age >35 years 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). This does not apply to women with a history of blood clots, including deep vein thrombosis, pulmonary embolism, strokes, or mini-strokes.

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

For more information call (301) 427-1584 or visit the Recommendations Summary page.