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Breast Cancer Medications for Risk Reduction

Breast Cancer Medications for Risk Reduction

Tamoxifen, raloxifene, and aromatase inhibitors have been shown to reduce the risk breast cancer, but they can have their own risks and side effects.

Who is at risk

Important risk factors for breast cancer include increasing age, family history of breast or ovarian cancer (especially among first-degree relatives and onset before age 50 years), history of atypical hyperplasia or other nonmalignant high-risk breast lesions, previous breast biopsy, and extremely dense breast tissue.

Symptoms

Breast cancer symptoms vary widely — from lumps to swelling to skin changes — and many breast cancers have no obvious symptoms at all.

What you can do

Tell your doctor if you have:

  • a history of stroke or blood clot;
  • liver disease;
  • high cholesterol or triglycerides (a type of fat in the blood);
  • a history of cataracts; or
  • if you are receiving chemotherapy or radiation.

Preventive service at no cost

Women, Increased Risk for Breast Cancer aged 35 or older

The USPSTF 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.

Why medication is important

Breast cancer is the most common nonskin cancer in women. The USPSTF found adequate evidence that treatment with these medications can significantly reduce the relative risk (RR) for invasive ER-positive breast cancer in postmenopausal women who are at increased risk for breast cancer.

What the medication is

Tamoxifen and raloxifene are selective estrogen receptor modulators that have been shown in randomized, controlled trials to reduce the risk for estrogen receptor (ER)–positive breast cancer. They have been approved by the U.S. Food and Drug Administration (FDA) for this indication.

Tamoxifen is not recommended for use in combination with hormone therapy or hormonal contraception or in women who are pregnant, those who may become pregnant, or breastfeeding mothers.

Aromatase inhibitors inhibit conversion of androgen to estrogen and can reduce risk of ER-positive breast cancer by decreasing the amount of estrogen available to bind to estrogen-sensitive epithelial cells. Aromatase inhibitors have been evaluated for risk reduction of breast cancer in clinical trials, although they are primarily used for treatment rather than risk reduction of primary cancer. Aromatase inhibitors are not currently approved by the US Food and Drug Administration for risk reduction of primary breast cancer.

Treatment

Treatment will depend on several factors. Your doctor will help you decide what is best for you.

Additional tips

  • Medications have side effects. Your doctor will tell you if taking these medications is right for you.
  • Have lab tests as directed.
  • Tell your doctor if you have any abnormal vaginal bleeding or spotting.

Resources

Tamoxifen