Chemoprevention-Historical Perspectives and Current Trends

Purpose of ReviewTo explore the landmark clinical trials which shaped contemporary chemoprevention practice, discuss trends in chemoprevention uptake, and highlight the obstacles faced along the way.Recent FindingsPoor chemoprevention uptake has been attributed to numerous factors, most notably fear of side effects and lack of physician recommendation. A lower dose of tamoxifen taken for a shorter period has been shown to be an effective alternative and harbors fewer side effects than the standard regimen for chemoprevention.SummaryDespite new regimens with more favorable side effect profiles and shorter treatment courses, chemoprevention uptake remains low. Education and decision-support interventions have not proven successful in addressing low uptake. In addition to ongoing trials aimed at maintaining the benefits of therapy while reducing adverse effects, a culture change among providers is needed to destigmatize these risk-reducing medications, with focus on referring appropriate women to specialized breast health centers.