title: Endocrine therapy for breast cancer prevention in high-risk women: clinical and economic considerations.
abstract: The global burden of breast cancer highlights the need for primary prevention strategies that demonstrate both favorable clinical benefit/risk profile and good value for money. Endocrine therapy with selective estrogen-receptor modulators (SERMs) or aromatase inhibitors (AIs) has been associated with a favorable clinical benefit/risk profile in the prevention of breast cancer in women at high risk of developing the disease. The available endocrine therapy strategies differ in terms of their relative reductions of breast cancer risk, potential side effects, and upfront drug acquisition costs, among others. This review highlights the clinical trials of SERMs and AIs for the primary prevention of breast cancer, and the cost-effectiveness /cost-utility studies that have examined their "value for money" in various health care jurisdictions.
authors.affiliation: a Department of Medicine , Dalhousie University at Queen Elizabeth II Health Sciences Centre , Halifax , Nova Scotia , Canada.
authors.forename: Amy G
authors.initials: AG
authors.lastname: Groom
authors.affiliation: a Department of Medicine , Dalhousie University at Queen Elizabeth II Health Sciences Centre , Halifax , Nova Scotia , Canada.
authors.forename: Tallal
authors.initials: T
authors.lastname: Younis
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000191:economics / Q000473:pathology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D006801:Humans; D011322:Primary Prevention / Q000379:methods; D012307:Risk Factors; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D020845:Selective Estrogen Receptor Modulators
keywords: Chemoprevention; aromatase inhibitors; breast cancer prevention; cost-effectiveness; cost-utility; endocrine therapy; selective estrogen-receptor modulators