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Therese B. Bevers, Deborah K. Armstrong, Banu Arun, Robert W. Carlson, Kenneth H. Cowan, Mary B. Daly, Irvin Fleming, Judy E. Garber, Mary Gemignani, William J. Gradishar, Helen Krontiras, Swati Kulkarni, Christine Laronga, Loretta Loftus, Deborah J. MacDonald, Martin C. Mahoney, Sofia D. Merajver, Ingrid Meszoely, Lisa Newman, Elizabeth Pritchard, Victoria Seewaldt, Rena V. Sellin, Charles L. Shapiro and John H. Ward

reduction agents/strategies, such as tamoxifen, raloxifene, and risk reduction surgery, have been identified. However, women and their physicians who are considering interventions to reduce risk for breast cancer must balance the demonstrated benefits with

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Therese B. Bevers, John H. Ward, Banu K. Arun, Graham A. Colditz, Kenneth H. Cowan, Mary B. Daly, Judy E. Garber, Mary L. Gemignani, William J. Gradishar, Judith A. Jordan, Larissa A. Korde, Nicole Kounalakis, Helen Krontiras, Shicha Kumar, Allison Kurian, Christine Laronga, Rachel M. Layman, Loretta S. Loftus, Martin C. Mahoney, Sofia D. Merajver, Ingrid M. Meszoely, Joanne Mortimer, Lisa Newman, Elizabeth Pritchard, Sandhya Pruthi, Victoria Seewaldt, Michelle C. Specht, Kala Visvanathan, Anne Wallace, Mary Ann Bergman and Rashmi Kumar

breast cancer screening and risk reduction strategies. For women without a personal history of breast cancer, risk factors for its development can be grouped into categories, including familial/genetic factors; factors related to age, demographics

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Arvind Bambhroliya, Mariana Chavez-MacGregor and Abenaa M. Brewster

cancer risk reduction medications Explain several strategies to educate women on breast cancer risk and risk reduction strategies Identify research areas to improve the use of risk reduction medication for women who are at high risk for breast cancer

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Therese B. Bevers

;282:2124 . 6. Cauley JA Norton L Lippman ME . Continued breast cancer risk reduction in postmenopausal women treated with raloxifene: 4-year results from the MORE trial. Multiple Outcomes of Raloxifene Evaluation . Breast Cancer Res Treat 2001 ; 65

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Robert H. Lurie Comprehensive Cancer Center of Northwestern University

Breast cancer is the most commonly diagnosed cancer in American women, with an estimated 214,640 cases and 41,430 deaths occurring in 2006. Estimating breast cancer risk for individual women is difficult, and most breast cancers are not attributable to risk factors other than female gender and increased age. Developing effective strategies for reducing breast cancer incidence is also difficult because few existing risk factors are modifiable and some potentially modifiable risk factors have social implications. Nevertheless, effective breast cancer risk reduction agents and strategies, such as tamoxifen, raloxifene, and risk reduction surgery, have been identified. These guidelines were developed to help women at increased risk for breast cancer and their physicians apply individualized strategies to reduce breast cancer risk.

For the most recent version of the guidelines, please visit NCCN.org

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Martin C. Mahoney

Tamoxifen and Raloxifene (STAR) P-2 trial . JAMA 2006 ; 295 : 2727 – 2741 . 24. Cauley JA Norton L Lippman ME . Continued breast cancer risk reduction in postmenopausal women treated with raloxifene: 4-year results from the MORE trial

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Kostandinos Sideras and Charles L. Loprinzi

cancer risk reduction be discussed and considered as an option for women with increased risk of developing breast cancer. 6 , 7 For postmenopausal women, the currently approved agents are tamoxifen and raloxifene, both recommended for a maximum of 5

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Therese B. Bevers

More than 15 years ago, tamoxifen was FDA-approved for breast cancer risk reduction in women at an increased risk of developing breast cancer. Since that time, raloxifene has also received FDA approval for this purpose. Both of these drugs halve

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Adam L. Cohen and John H. Ward

after lumpectomy for DCIS. These strategies must balance the benefit from reducing breast cancer with risks to women who are otherwise asymptomatic, most of whom would not develop breast cancer. This article reviews what is known about risk reduction

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Eleni Linos and Walter C. Willett

The association between diet and breast cancer risk has been investigated extensively and has led to some recommendations for prevention. Research suggests that maintaining a healthy weight may reduce the risk for breast cancer after menopause. Additionally, alcohol increases the risk for breast cancer even at moderate levels of intake, and women who drink alcohol also should take sufficient folate, which can mitigate this excess risk. Interesting questions for future research include the role of soy products, red meat, energy balance, and vitamin D, with particular attention to timing of exposure in early life. Breast cancer is a heterogeneous disease, and dietary factors may differentially affect certain breast cancer subtypes; future studies should therefore attempt to characterize associations according to tumor characteristics.