HEALTH & SCIENCE

Chemoprevention of breast cancer applies to only a few

Doctors say the current appeal is extremely limited, but experts say this approach is only the beginning of new cancer prevention.

By Victoria Stagg Elliott, AMNews staff. Oct. 25, 2004.

Asking a woman about her age and her breast cancer risk can pinpoint who fits into the small percentage for whom taking the drug tamoxifen for the primary prevention of breast cancer is a realistic option.

The drug is also only cost effective for those in their 40s who are at high risk of the disease, according to two studies published last month. The authors hope their findings will enable physicians to target the extensive discussion required before initiating chemoprevention of breast cancer to those who need it the most.

"I hope this saves doctors some time," said Russell Harris, MD, MPH, associate professor of medicine at the University of North Carolina at Chapel Hill School of Medicine. "It may help focus discussions where they need to go. Tamoxifen can prevent breast cancer, but it can do some bad things, too."

Dr. Harris's study, published in the Sept. 27 Archives of Internal Medicine, found that asking about breast cancer family history and previous breast biopsies was enough to exclude the majority of women from long, complicated talks about the risks and benefits of this type of breast cancer chemoprevention.

The other study, appearing in the September issue of Obstetrics & Gynecology, found that the drug was cost effective for women ages 40 to 50 who were at significant risk for breast cancer. It also could be cost effective for older women depending on their fear of breast cancer, level of risk and whether they had a uterus.

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