Breast cancer risk reduction: What do we know and where should we go?

Clinicians should be aware of the advances in breast cancer risk assessment and risk-reduction therapy. The modified Gall model is appropriate for pre dicting the risk of developing breast cancer within the next 5 years for mo st women between ages 35 and 75. Tamoxifen has been approved by the U.S. Fo od and Drug Administration (FDA) for reduction of breast cancer risk in wom en aged 35 and older who meet the threshold risk for breast cancer. Raloxif ene is being compared with tamoxifen in the clinical trial, STAR (a Study o f Tamoxifen and Raloxifene), which is now enrolling postmenopausal women ag ed 35 or older. The risks and benefits of therapy to reduce breast cancer r isk are reviewed here. Processes for comparison of risks and benefits and f or shared decision making are outlined.