To the Editor: Dr Cummings and colleagues1 found that serum estradiol levels may be useful
to identify women who would be most likely to benefit from prophylactic use
of raloxifene to prevent breast cancer. Application of their results, however,
which used a "sensitive" assay, may not be directly applicable to the commercially
available assays for serum estradiol that are generally used in clinical practice.
The apparent average value for estradiol in their population of postmenopausal
women using this assay was 2.93 pg/mL, which is much lower than the range
of 10 to 20 pg/mL used in daily clinical practice.2
Thus, their results must be adjusted before they can be applied to clinical
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