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Evista for Breast Cancer Prevention

Does Evista have side effects?

Although Evista can reduce the likelihood of invasive breast cancer, it's important to be aware of its serious side effects. Those serious side effects include:

  • increased chance of blood clots in the lungs and legs
  • increased chance of stroke in women with coronary artery disease

Other milder side effects include:

  • leg cramps
  • joint pain
  • swelling of the extremities
  • flu-like symptoms
  • sweating and hot flashes
  • trouble sleeping
  • vaginal dryness and discomfort

Experts caution that some women who take Evista will still get invasive breast cancer. So women need to consider the pros and cons of taking a medication with very serious side effects.

Who should take Evista for breast cancer prevention?

Breast cancer is more commonly found in women over 60. So women who are over 60 may benefit the most from Evista. Also, if you are a woman who has a family history of breast cancer or who has a genetic predisposition, you may benefit. Other factors that can increase your risk of developing invasive breast cancer include a previous lobular carcinoma in situ (a premalignant condition) diagnosis, a history of frequent breast biopsies, having your first child at a later age, or starting your periods at a later age. Your doctor can help identify your own risk for breast cancer.

Who should not take Evista for breast cancer prevention?

The FDA advises that women with the following conditions not take Evista:

  • women who are pregnant or planning to become pregnant
  • women with present or past blood clots in the eyes, lungs, or legs
  • women taking cholestyramine, a cholesterol-lowering drug
  • women taking supplemental estrogen
  • women who are premenopausal


How does Evista compare to tamoxifen?

Evista and tamoxifen, another SERM, have similar results and side effects in preventing invasive breast cancer, although Evista had less uterine cancers involved with its use.

In the last decade, several studies investigated the effects of Evista and tamoxifen in more than 37,000 women. For instance, one study that involved more than 19,000 women at high risk of developing breast cancer found that both medications had similar results in reducing invasive breast cancer. Unlike tamoxifen, however, Evista was not shown to reduce noninvasive forms of breast cancer. Noninvasive forms include ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS).

Both Evista and tamoxifen may increase the risk of developing blood clots and strokes. Some findings suggest that Evista might be less likely to cause clots, pulmonary embolisms, and strokes than tamoxifen. But other studies say there is no difference. Both raloxifene and tamoxifen carry risks. Because of the possible side effects, you and your doctor should cautiously weigh the benefits and risks of using either drug to prevent invasive breast cancer.

WebMD Medical Reference

Reviewed by Arnold Wax, MD on June 26, 2012
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