According to Andrea De Censi, MD, of the E.O. Ospedali Galliera in Genoa, Italy, the invited discussant of the paper presented by Paul Goss, MD, PhD, at the 2011 ASCO Annual Meeting, “MAP.3 provides a paradigm shift for breast cancer prevention. Avoiding breast cancer with manageable toxicity is possible today.”

Dr. De Censi maintained that the MAP.3 trial has altered the standard of preventive care by showing exemestane’s “potential impact on a deadly disease.” While tamoxifen is still favored for at-risk premenopausal women, exemestane may be a preferred option in the postmenopausal group, given that the currently indicated drugs have not been well received due to concerns over adverse events, he said.

“But we must remain aware that a drug that affects cell growth cannot be totally devoid of adverse effects,” he added. Individualized dosing and intermittent administration may help ameliorate toxicity. ■

Disclosure: Dr. De Censi reported no potential conflicts of interest.