Benefit/risk assessment for breast cancer chemoprevention with raloxifene or tamoxifen for women age 50 years or older Full Text
Journal of Clinical Oncology, 05/05/2011
Clinical Article
Freedman AN et al. –The authors developed a benefit/risk index to quantify benefits from chemoprevention with tamoxifen or raloxifene. This index can complement clinical evaluation in deciding whether to initiate chemoprevention and in comparing the benefits and risks of raloxifene versus tamoxifen.
Methods- Baseline incidence rates of IBC and other health outcomes, absent raloxifene and tamoxifen, estimated from breast cancer chemoprevention trials; Surveillance, Epidemiology and End Results Program; Women's Health Initiative
- Effects of raloxifene and tamoxifen estimated from STAR and Breast Cancer Prevention Trial
- Assigned weights to health outcomes to calculate net benefit from raloxifene compared with placebo and tamoxifen compared with placebo
- Risks and benefits of treatment with raloxifene or tamoxifen depend on age, race, breast cancer risk, and history of hysterectomy
- Over 5-year period, postmenopausal women with an intact uterus had better benefit/risk index for raloxifene than for tamoxifen
- For postmenopausal women without a uterus, benefit/risk ratio was similar
- Benefits and risks of raloxifene and tamoxifen described in tables that can help identify groups of women for whom benefits outweigh risks
