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September 3, 2019

Medications to Reduce Breast Cancer Risk: Promise and Limitations

Author Affiliations
  • 1Division of Women’s Health, Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Division of General Internal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
  • 3Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
JAMA. 2019;322(9):821-823. doi:10.1001/jama.2019.9689

Breast cancer is diagnosed among more than a quarter of a million women in the United States each year.1 Tamoxifen, raloxifene, and aromatase inhibitors can reduce women’s risk of developing breast cancer. With so many women at risk for breast cancer, these drugs have the potential to substantially affect public health. In this issue of JAMA, the US Preventive Services Task Force (USPSTF) reports updated recommendations regarding use of these medications.2 The task force recommends that clinicians “offer to prescribe risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, to women who are at increased risk for breast cancer and at low risk for adverse medication effects” (B recommendation). The task force further recommends against the use of risk-reducing medications in women not at increased risk of breast cancer, for whom harms likely outweigh benefits (D recommendation). These recommendations are similar to those in the 2013 USPSTF Recommendation Statement,3 except that the 2019 Recommendation Statement now includes aromatase inhibitors.

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