Tamoxifen prevention of breast cancer: an instance of the fingerpost.

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Abstract
Tamoxifen as a chemopreventive agent has produced a fundamental change in the outlook for controlling breast cancer. Tamoxifen in the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 Breast Cancer Prevention Trial (BCPT) achieved a striking 49% reduction in the incidence of invasive breast disease in women at increased risk of breast cancer (1). With this finding, the Food and Drug Administration (FDA) approved tamoxifen for risk reduction in this setting, marking the historic first FDA approval of any agent for cancer risk reduction. The BCPT finding and FDA approval have created a paradigm shift toward pharmacologic preventive approaches (i.e., chemoprevention) for controlling breast cancer.