Raloxifene, a selective estrogen receptor (ER) modulator, lowers the risk of invasive ER-positive breast cancers but not other types of breast cancers in women who have or are at high risk of coronary heart disease, researchers report in the June 18 issue of the Journal of the National Cancer Institute.

Deborah Grady, M.D., from the University of California San Francisco, and colleagues randomly assigned 10,101 postmenopausal women with coronary heart disease or risk factors for coronary heart disease to 60 mg/day raloxifene or placebo for a median of 5.6 years. Data previously reported showed that raloxifene reduced the risk of invasive breast cancer and vertebral fractures but not cardiovascular events, the authors note.

The researchers found that raloxifene reduced the risk of invasive breast cancer (hazard ratio 0.56, absolute risk reduction 1.2 per 1000 women treated for one year), as shown previously. This consisted of a lower risk of ER-positive tumors (HR, 0.45), but not non-invasive breast cancer or invasive ER-negative tumors, they note. The reduced incidence of invasive breast cancer was similar regardless of factors such as age, body mass index, family history, postmenopausal hormone use and five-year estimated risk of invasive breast cancer.

"Which women might consider taking raloxifene to reduce the risk of breast cancer?…Assuming the relative risks from the RUTH [Raloxifene Use for the Heart] trial apply to women in the general population, the best benefit to risk ratio would occur in women at high risk of breast cancer and osteoporosis and at low risk of venous thrombosis and stroke," Grady and colleagues write.

The study was funded by Eli Lilly and Company.

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