Abstract
Trials with tamoxifen have clearly shown that estrogen receptor-positive breast cancer risk can be reduced at a late stage in the natural history with prophylactic agents. Approximately half of the cases were prevented. The current challenge is to achieve this or better efficacy, and reduce side effects. A recent trial found that the selective estrogen receptor modulator raloxifene has similar efficacy to tamoxifen but fewer side effects. Long-term Phase III trials are currently underway studying two aromatase inhibitors. Results from other studies suggest that these agents have a better side-effect profile and may prevent 70-80% of receptor-positive breast cancers. New agents are needed for receptor-negative breast cancer and several possibilities are currently under investigation.
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