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Chemoprevention of Breast Cancer

Joyce A. O'Shaughnessy, MD
JAMA. 1996;275(17):1349-1353. doi:10.1001/jama.1996.03530410063035.
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CASE REPORT  A 46-year-old woman was found on mammography to have a solid 1-cm mass in her right breast. Excisional biopsy identified a fibroadenoma, and 3 foci of cribriform ductal carcinoma in situ (DCIS) with necrosis were incidentally noted, in addition to areas of lobular neoplasia and atypical ductal hyperplasia (ADH). The surgical margins were clear of DCIS, and her right breast was treated with radiotherapy. This patient's 50-year-old sister had recently been diagnosed with breast cancer. With lobular and ductal neoplasia placing this patient at increased risk of developing breast cancer in her other breast, the patient questioned her physicians regarding the appropriateness of her taking tamoxifen as a chemopreventive agent and whether any genetic studies could be done on her breast tissue to more accurately predict the risk of her developing a second malignancy.The biopsy showed that this woman is at high risk for developing breast cancer


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