Selective estrogen receptor modulators SERMs

Chemo Secrets From a Breast Cancer Survivor

Breast Cancer Survivors

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Tamoxifen: 1 risk of contralateral breast cancer in adjuvant setting; risk-benefit unclear when given as 1° prevention in Pts at T risk: I invasive breast cancer, butr DVT & uterine CA risk, and ? t in all-cause mortality (lancet 2002J60.817)

Raloxifene: i risk of invasive breast cancer & vertebral fx. 1 risk of stroke & DVT PE (rutrnqai 2006:355:125); - tamoxifen in prevention of breast cancer w 1 risk of DVT PE & cataracts, trend towards 1 uterine cancer (star.jama 2006:295:2727)

Aromatasc inhibitors under study

• BRCA1 2 carriers: several options, including intensified surveillance as described above

Prophylactic bilateral mastectomy (NEJM 2001:345 159) and bilateral sal pi ngo-oophorectomy (i risk of ovarian and breast cancer, nejm 2002:346:160*jama 2006:296.185) are effective.

Chemoprevention: limited data supports use of tamoxifen for risk reduction

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