RT Journal
A1 Lewis CL, Kinsinger LS, Harris RP, Schwartz RJ
T1 Breast cancer risk in primary care: Implications for chemoprevention
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2004
FD September 27
VO 164
IS 17
SP 1897
OP 1903
DO 10.1001/archinte.164.17.1897
UL http://dx.doi.org/10.1001/archinte.164.17.1897
AB Background 
    Some women may benefit from taking tamoxifen citrate for breast cancer prevention if the probability of benefit outweighs that of adverse events. We determined the proportion of women aged 40 to 69 years attending general internal medicine practices who were potentially eligible for tamoxifen chemoprevention and calculated the maximum proportion of breast cancers that could be prevented.Methods 
    Six hundred five women aged 40 to 69 completed self-administered questionnaires in the waiting rooms of 10 general internal medicine practices in North Carolina in 2001.Results 
    Among white women, 9.0% (95% confidence interval [CI], 5.1%-15.2%) in their 40s, 24.0% (95% CI, 18.2%-31.0%) in their 50s, and 53.4% (95% CI, 46.1%-61.3%) in their 60s had a 5-year Gail model estimated breast cancer risk of 1.66% or greater. Among black women, 2.9% (95% CI, 0%-15.0%) in their 40s, 7.1% (95% CI, 1.1%-24.4%) in their 50s, and 13.0% (95% CI, 3.1%-34.3%) in their 60s had a similar risk. When adverse events were considered in white women, 10% or fewer in all age groups were potentially eligible for chemoprevention. The maximum proportion of breast cancers prevented in eligible women was 6.0% to 8.3%.Conclusions 
    Small numbers of women in primary care practices are eligible for discussions about chemoprevention; the maximum proportion of breast cancers prevented if eligible women take tamoxifen is also small. Challenges lie in targeting discussions to the most appropriate women and in finding new chemoprevention strategies that have less risk of harms.