Download Decision Aid Tool: Medications to Reduce the Risk of Developing

Decision Aid Tool: Medications to Reduce the Risk of Developing Breast Cancer
This tool is to help women who have an increased risk of developing breast cancer to decide whether or not medication to help
reduce the risk of developing breast cancer is right for them. The medications discussed are Tamoxifen, Raloxifene, and Exemestane.
This aid is not intended to be a comprehensive guide, but rather a starting point for a discussion with your doctor. Talk to your
doctor about increased risks for developing breast cancer and the treatments that are available.
Tamoxifen
Who can take this
medication?
 ≥ 35 years of age
 Pre- or postmenopausal
a
 5-year projected risk ≥ 1.66%
b
or with LCIS
What are the
possible benefits?
Raloxifene
 ≥ 35 years of age
 Postmenopausal women
a
 5-year projected risk ≥ 1.66%
or with LCIS
Exemestane*
 ≥ 35 years of age
 Postmenopausal
a
 5-year projected BC risk ≥1.66%
All three drugs may reduce the risk of invasive breast cancer, especially in women who develop estrogen
receptor positive breast cancer (that is breast cancer that can be treated with hormonal therapy).

It may be also be protective
for up to 10 years, even when
taken for only 5 years

It may also treat or prevent
osteoporosis

It may also treat early or
advanced estrogen receptor
positive breast cancer
What are possible
rare side effects
that women may
experience?
What are more
common side
effects that women
may experience?



Thromboembolic events
Cardiovascular events
Endometrial cancer


Thromboembolic events
Cardiovascular events

A decrease in bone mineral
density


Hot flashes, leg cramps,
peripheral edema, flu
syndrome, arthralgia, and
sweating

Hot flashes, sweats, arthralgia,
headache, and insomnia
Who should not
take this
medication?

Hot flashes, sweats, vaginal
discharge, dryness, and
menstrual irregularities
Bone loss for premenopausal
women
Women with a prior history of
blood clots in the veins or in
the lung, or with stroke or
stroke-like events
Women who are, or may
become, pregnant, or nursing
mothers

Women who are premenopausal
Women with a prior history
of blood clots in the veins or
in the lung, or with stroke or
stroke-like events

Women who are premenopausal


You may experience some of
 You may experience some of  You may experience some of
the side effects listed above,
the side effects listed above,
the side effects listed above,
although the majority tend to
although the majority tend to
although the majority tend to
go away after treatment is
go away after treatment is
go away after treatment is
complete.
complete.
complete.
 Women report fewer breast
complaints and headaches,
especially during treatment.
 There are some reports of a
slight increase in problems
related to sexual functioning.
a
According to the National Cancer Institute Breast Cancer Risk Assessment Tool.
b
Recommendations are based on the 2013 ASCO Breast Cancer Risk Reduction Guideline Update, www.asco.org/guidelines/bcrr
*Exemestane is not approved by FDA for breast cancer prevention
How could it affect
quality of life?


Additional questions:
What is the comparative effectiveness of these three drugs?
What other resources are available to me in making my decision?
The Expert Panel for this Guideline Update wishes to express its gratitude to Rose Z. Morrison for her assistance in the development of this tool.