With the exception of skin cancer, breast cancer is the most common cancer among American women, and the second leading cause of cancer deaths in the US. Women with a high risk of developing breast cancer have the option of lowering their risk by taking certain medications.
The US Preventive Services Task Force (USPSTF) recently made two updates to their recommendations for risk-reduction medications:
“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”. This recommendation is for women who have never been diagnosed with breast cancer, but have at least a 3% risk of developing the disease within 5 years.
“The USPSTF recommends against the routine use of risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, in women who are not at increased risk for breast cancer… This recommendation applies to asymptomatic women 35 years and older, including women with previous benign breast lesions on biopsy such as atypical ductal hyperplasia or lobular hyperplasia, and LCIS. This recommendation does not apply to women who have a current or previous diagnosis of breast cancer or ductal carcinoma in situ.” In this group of patients, the side effects associated with taking these medications would likely outweigh the prevention benefit.
The USPSTF based its recommendations on the evidence of the benefits and potential side effects of taking any of these risk-reducing medications, and an assessment of the balance. The USPSTF does not consider the cost of care in any of their assessments.
The USPSTF also states that it recognizes that clinical decisions involve more considerations than evidence alone. We strongly encourage a shared decision-making approach between patients and their healthcare team to determine what’s best for you. If you would like to learn if you could benefit from taking a risk-reducing medication and whether taking one is right for you, please discuss the full range of options, risks and benefits with your physician.
You can read the full USPSTF statement here.