title: Update on breast cancer risk prediction and prevention.
abstract: OBJECTIVE
  Breast cancer is the most common cancer in women worldwide. This review will focus on current prevention strategies for women at high risk.
  
  
  RESULTS
  The identification of women who are at high risk of developing breast cancer is key to breast cancer prevention. Recent findings have shown that the inclusion of breast density and a panel of low-penetrance genetic polymorphisms can improve risk estimation compared with previous models. Preventive therapy with aromatase inhibitors has produced large reductions in breast cancer incidence in postmenopausal women. Tamoxifen confers long-term protection and is the only proven preventive treatment for premenopausal women. Several other agents, including metformin, bisphosphonates, aspirin and statins, have been found to be effective in nonrandomized settings.
  
  
  CONCLUSIONS
  There are many options for the prevention of oestrogen-positive breast cancer, in postmenopausal women who can be given a selective oestrogen receptor modulator or an aromatase inhibitor. It still remains unclear how to prevent oestrogen-negative breast cancer, which occurs more often in premenopausal women. Identification of women at high risk of the disease is crucial, and the inclusion of breast density and a panel of genetic polymorphisms, which individually have low penetrance, can improve risk assessment.
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
authors.forename: Ivana
authors.initials: I
authors.lastname: Sestak
authors.forename: Jack
authors.initials: J
authors.lastname: Cuzick
mesh_terms: D017668:Age of Onset; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001241:Aspirin; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control*; D004164:Diphosphonates; D005260:Female; D006801:Humans; D008687:Metformin; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control*; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D013629:Tamoxifen / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D047072:Aromatase Inhibitors; D014408:Biomarkers, Tumor; D004164:Diphosphonates; D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen; D008687:Metformin; D001241:Aspirin