American Society of Clinical Oncology Clinical Practice Guideline

The updated pharmacologic interventions for breast cancer risk reduction from the 2009 American Society of Clinical Oncology (ASCO) guideline was published by the American Society of Clinical Oncology in July 2013.

The authors undertook a systematic review of randomized controlled trials and meta-analyses published from June 2007 through June 2012 using MEDLINE and Cochrane Collaboration Library. The primary outcome of interest was breast cancer incidence (invasive and noninvasive). The secondary outcomes included breast cancer mortality, adverse events, and net health benefits. Guideline recommendations were revised based on an Update Committee's review of the literature.

Nineteen articles met the selection criteria and six chemoprevention agents were identified: tamoxifen, raloxifene, arzoxifene, lasofoxifene, exemestane, and anastrozole.

Should women take calcium and vitamin D supplements after menopause for bone health? Recommendations conflict, and opinions are strong. But now, an analysis from the major Women's Health Initiative (WHI) trial throws weight on the supplement side—at least for women taking hormones after menopause. The analysis was published 26 June 2013 in Menopause, the journal of The North American Menopause Society.

Among the nearly 30,000 postmenopausal women in the hormone trial, some 8,000 took supplemental calcium (1,000 mg/day) and vitamin D (400 iu/day), and some 8,000 took look-alike placebos. These women came from all the hormone groups in the study—those who took estrogen plus a progestogen (required for women with a uterus), those who took estrogen alone, and those who took the hormone look-alike placebos. The researchers looked at how the rates of hip fracture differed among women who took hormones and supplements, those who took hormones alone, and those who took neither.