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To the Editor: Dr Vogel and colleagues¹ reported the results of the Study of Tamoxifen and Raloxifene (STAR) P-2 trial. I was disappointed that in the accompanying Editorial, Drs Gradishar and Cella² did not comment on the role of the effects of raloxifene on the breast when choosing an agent to treat a patient with osteoporosis or osteopenia who has breast cancer risk factors. The MORE³ and CORE⁴ trials, while not performed on a group at high risk for breast cancer, showed a significant reduction in new-onset breast cancer. This may not be widely known because raloxifene is not approved for any breast indication.

Gradishar and Cella state that "decision making for an individual patient who is considering a preventive agent to reduce the risk of breast cancer must also take into account other health issues that may very well outweigh the risk of developing breast cancer." I would further . . . [Full Text of this Article]

Steven R. Goldstein, MD
steven.goldstein@med.nyu.edu
Department of Obstetrics and Gynecology
New York University School of Medicine
New York

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RELATED LETTER

Raloxifene vs Tamoxifen—Reply
William J. Gradishar and David Cella
JAMA. 2007;297(3):264.
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Effects of Tamoxifen vs Raloxifene on the Risk of Developing Invasive Breast Cancer and Other Disease Outcomes: The NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 Trial
Victor G. Vogel, Joseph P. Costantino, D. Lawrence Wickerham, Walter M. Cronin, Reena S. Cecchini, James N. Atkins, Therese B. Bevers, Louis Fehrenbacher, Eduardo R. Pajon, Jr, James L. Wade, III, André Robidoux, Richard G. Margolese, Joan James, Scott M. Lippman, Carolyn D. Runowicz, Patricia A. Ganz, Steven E. Reis, Worta McCaskill-Stevens, Leslie G. Ford, V. Craig Jordan, Norman Wolmark, and for the National Surgical Adjuvant Breast and Bowel Project (NSABP)
JAMA. 2006;295(23):2727-2741.
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