Advertisement

USPSTF Issues Final Recommendation Statement on Medications for the Risk Reduction of Primary Breast Cancer in Women

Advertisement

Key Points

  • The USPSTF recommends that clinicians offer to prescribe risk-reducing medications, such as tamoxifen or raloxifene, to women who are at increased risk for breast cancer and at low risk for adverse medication effects.
  • The USPSTF recommends against the routine use of these drugs for risk reduction of primary breast cancer in women who are not at an increased risk for the disease.
  • Clinical considerations for conducting a formal breast cancer risk assessment on patients include a woman’s increasing age, family history of breast or ovarian cancer, history of atypical hyperplasia or other nonmalignant high-risk breast lesions, previous breast biopsy, and extremely dense breast tissue.

The U.S. Preventive Services Task Force (USPSTF) released today its final recommendation statement on medications to reduce the risk of primary breast cancer in women. Clinicians are recommended to prescribe risk-reducing medications, such as tamoxifen or raloxifene, for women who are at increased risk for breast cancer and at low risk for adverse medication effects, according to the statement. However, the USPSTF recommends against the routine use of these drugs for risk reduction of primary breast cancer in women who are not at an increased risk for breast cancer.

Tamoxifen and raloxifene have been shown in randomized controlled trials to reduce the risk of estrogen receptor (ER)-positive breast cancer and have been FDA approved for this indication.

The statement was published in the September 24 online issue of Annals of Internal Medicine.

Assessing Breast Cancer Risk Status

According to the Task Force, clinical considerations for conducting a formal breast cancer risk assessment on patients include a woman’s increasing age, family history of breast or ovarian cancer—especially among first-degree relatives and onset before age 50—history of atypical hyperplasia or other nonmalignant high-risk breast lesions, previous breast biopsy, and extremely dense breast tissue. In general, women with an estimated 5-year risk of 3% or greater (based on the National Cancer Institute’s Breast Cancer Risk Assessment Tool) are more likely to benefit from tamoxifen or raloxifene, said the statement. The USPSTF found that the benefits of these medications for breast cancer risk reduction are no greater than small in women who are not at increased risk for the disease.

In July, ASCO released its clinical practice guideline on interventions, including tamoxifen, to reduce the risk of ER-positive breast cancer in women aged 35 or older who are at an increased risk for breast cancer. ASCO also recommended that raloxifene and exemestane be discussed as options for breast cancer risk reduction in postmenopausal women.

According to the USPSTF statement, an estimated 232,340 new cases of breast cancer will be diagnosed in 2013, and 39,620 women will die from the disease. In the United States, breast cancer mortality rates are highest among African American women.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


Advertisement

Advertisement



Advertisement