Breast cancer is the second most common cancer in the world and the most common cancer among women in the United States and in other Western countries.1 The incidence rate is about 5 times higher in Western countries than in developing countries.2 Measurable success in multifaceted approaches for prevention and treatment has reduced breast cancer mortality in the United States and in a number of Western countries.3 These approaches include mammography screening, identification of very high-risk families with deleterious mutations within the BRCA1 and BRCA2 genes, and optimal use of adjuvant therapies with endocrine agents, chemotherapeutic agents, and biologically targeted therapy in patients with ERBB2-positive (HER2) disease.4- 7 A woman's risk of developing breast cancer in the next few years and/or her lifetime risk can be estimated using risk assessment tools.8 In women at risk of developing breast cancer, pharmacological interventions with antiestrogens (tamoxifen and raloxifene) can reduce this risk.9 However, these pharmacological interventions are associated with significant adverse effects and have not been adopted on a large scale.10 Aromatase inhibitors also are under evaluation for the at-risk population.
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