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NSABP P-1

PreventionOncology1998
PurposePrevention
FieldOncology
Year1998
Key FindingTamoxifen prevents breast cancer in high risk women

About the Trial

The Breast Cancer Prevention Trial randomized 13,388 women at elevated breast cancer risk to 5 years of tamoxifen or placebo. Tamoxifen cut invasive breast cancer by 49 percent, an effect confined to estrogen receptor positive tumors. The price: more endometrial cancer and venous clots, especially in women over 50. The trial proved chemoprevention of a solid tumor was possible, a paradigm shift. It also popularized formal risk estimation with the Gail model. STAR later showed raloxifene matched prevention with less uterine cancer. Uptake stayed low due to side effect fears, but the concept now extends to aromatase inhibitors for postmenopausal women at high risk.

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