Despite strong evidence that it is efficacious, chemoprevention has been underused in eligible women. Reasons offered not to adopt and initiate strategies to reduce the risk of breast cancer include the fear of adverse effects, medication costs, lack of reasonably accurate and feasible methods for assessing an individual's personal risk, and lack of established risk thresholds that maximize benefit and minimize harms. The article by Macdonald and colleagues remind us that the problem of lack of uptake of risk-reducing medications for breast cancer remains a worldwide clinical challenge despite endorsements from national and international organizations that recommend the use of risk-reducing medications for breast cancer with level I evidence. Several strategies are suggested to improve uptake and utilization of safe and effective chemoprevention medications with high therapeutic indices. See related article by Macdonald et al., p. 131

中文翻译：

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早该实施降低乳腺癌风险的策略

尽管有强有力的证据表明它是有效的，但化学预防在符合条件的女性中并未得到充分利用。不采取和启动降低乳腺癌风险的策略的原因包括担心副作用、药物成本、缺乏合理准确和可行的方法来评估个人的个人风险，以及缺乏既定的风险阈值来最大化收益和最小化害。Macdonald 及其同事的文章提醒我们，尽管国家和国际组织推荐使用降低风险的药物治疗 I 级乳腺癌，但缺乏降低风险的乳腺癌药物的摄入问题仍然是一个全球性的临床挑战。证据。提出了几种策略来提高安全有效的具有高治疗指数的化学预防药物的吸收和利用。参见 Macdonald 等人的相关文章，第 15 页。131