Agent	Recommendation	Dosage
Tamoxifen	May be offered to reduce the risk of estrogen receptor–positive invasive breast cancer in premenopausal or postmenopausal women with a 5-year projected breast cancer risk ≥ 1.66 percent* or with lobular carcinoma in situ; risk reduction benefit continues for at least 10 years; impact on breast cancer–related mortality is unknown	20 mg per day for 5 years
	Not recommended for use in women with a history of deep venous thrombosis, pulmonary embolism, stroke, or transient ischemic attack
	Combined use of tamoxifen for breast cancer prevention and hormone therapy currently not recommended
	Follow-up should include baseline gynecologic examination before initiation of treatment and annually thereafter, with timely workup of abnormal vaginal bleeding
	Risks and benefits should be given careful consideration during the decision-making process
Raloxifene (Evista)	May be offered to reduce the risk of estrogen receptor–positive invasive breast cancer in postmenopausal women with a 5-year projected breast cancer risk = 1.66 percent* or with lobular carcinoma in situ; impact on breast cancer–related mortality is unknown	60 mg per day for 5 years
	May be used longer than 5 years in women with osteoporosis in whom breast cancer risk reduction is a secondary benefit
	Should not be used for breast cancer risk reduction in premenopausal women
	Not recommended for use in women with a history of deep venous thrombosis, pulmonary embolism, stroke, or transient ischemic attack
	Risks and benefits should be given careful consideration during the decision-making process
Aromatase inhibitors or fenretinide†	Not recommended for use outside of the clinical trial setting to lower breast cancer risk	NA