The lack, need, and opportunities for decision-making and informational tools to educate primary-care physicians and women about breast cancer chemoprevention.
This perspective on Vogel et al. (beginning on page 696 in this issue of the journal) examines tamoxifen and raloxifene prescription patterns and why these agents are little used for breast cancer prevention despite their effectiveness in definitive trials, Food and Drug Administration approval, and American Society of Clinical Oncology Guidelines Committee endorsement for this purpose. The complexity of weighing the positive and negative aspects of the drugs and estimating net benefit is discussed, as is the need for informational resources such as interactive Internet-based tools to allow better individualized decisions about the options for chemoprevention.
University of Texas Health Sciences Center at San Antonio, 78229, USA. ravdin@uthscsa.edu
Peter M
PM
Ravdin
D000230:Adenocarcinoma / Q000453:epidemiology / Q000517:prevention & control*; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D003661:Decision Support Techniques; D004363:Drug Utilization; D004967:Estrogens; D005260:Female; D006801:Humans; D015994:Incidence; D020407:Internet; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D009376:Neoplasms, Hormone-Dependent / Q000453:epidemiology / Q000517:prevention & control*; D010353:Patient Education as Topic; D010821:Physicians, Family / Q000193:education* / Q000523:psychology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D020849:Raloxifene Hydrochloride / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D013629:Tamoxifen / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
D004967:Estrogens; D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen; D020849:Raloxifene Hydrochloride