Reader Remarks on:

SERMs for Breast Cancer Chemoprophylaxis

raloxifene
VTE and SERMS

raloxifene

Yadon Arad, 4 Nov 2009 1:51 PM EST

Competing interests: None declared

VTE is usually not life threatening, unlike cancer. This suggest that at least for Raloxifene, the benefit, including prevntion of osteoporosis, far outweighs the risks. Consider combining with zolendronic acid once a year to further decrease osteoporosis as well as prevent metastases if breast CA were to occur.

VTE and SERMS

D. S. Skura, 1 Dec 2009 9:37 PM EST

Competing interests: None declared

The statement that VTE are rarley life threatening is foolhardy. VTE are life altering with comorbidities including need for anticoagulants. VTE do take lives.

For osteoporosis treatment oral bisphosphonates do the job much more effectively and don't cause gyny cancers.

Stopping the oral bisphosphonate after 5-6 yrs of use will decrease the risks of bisphophonate related bone diseases. If a woman has a strong risk of breast cancer then a SERM makes sense but to expose all women to the risk of VTE with a less effective drug for osteoporosis is not good judgement. I am leary of IV bisphosphonates until better dosing guidelines and length of treatment are defined.

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