© 1999 by Oxford University Press
Journal of the National Cancer Institute, Vol. 91, No. 21, 1792-1793,
November 3, 1999
© 1999 Oxford University Press
EDITORIALS |
Risk/Benefit Assessment of Tamoxifen to Prevent Breast Cancer—Still a Work in Progress?
Affiliations of authors: A. L. Taylor, J. T. Wright, Jr., Department of Medicine, Case Western Reserve University, Cleveland, OH; L. L. Adams-Campbell, Howard University Cancer Center, Division of Epidemiology and Biostatistics, Howard University College of Medicine, Washington, DC.
Correspondence to: Jackson T. Wright, Jr., M.D., Ph.D., Department of Medicine, Case Western Reserve University, 10900 Euclid Ave., Wood Bl W-165, Cleveland, OH 44106-4982 (e-mail: jxw20@po.cwru.edu).
The selective estrogen receptor modulators (SERMs), e.g., tamoxifen and raloxifene, represent an exciting new class of therapeutic agents, which may prove to be effective against a wide variety of conditions, including breast cancer, osteoporosis, and potentially other conditions. There are two principal limitations to the use of the currently available SERMs. First, the specificity of the mix of agonist and antagonist actions is limited. Newer agents with greater specificity hold the promise for highly targeted therapeutic actions with fewer undesirable side effects. Second, clinical trial data showing which populations benefit or suffer excessive risk from treatment with SERMs are very limited. It is with respect to this second limitation that Gail et al. (1), reporting in this issue of the Journal, have proposed estimates of benefits and risk for the use of tamoxifen for the prevention of breast cancer.
The authors use data, based primarily on the Breast
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