Primary prevention of breast cancer: new approaches

Lifestyle changes, such as exercise, might reduce the risk of breast cancer. Tamoxifen and raloxifene reduce the risk of breast cancer but have potential adverse effects and, therefore, should be considered by women at high risk of breast cancer. Breast density is a strong risk factor for breast cancer; assessment of breast density can be combined with risk factors to estimate a woman's risk of breast cancer. I propose that a woman's risk of breast cancer be assessed along with her screening mammogram with consideration of chemoprevention for those at high risk.