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A 1992 editorial in the Journal foreshadowed a role for the selective estrogen-receptor modulator (SERM) tamoxifen in breast-cancer chemoprevention because of its efficacy in the treatment of early-stage estrogen-receptor–positive breast cancer, as well as its favorable toxicity profile.¹ Nearly 20 years and four randomized clinical trials later, we know that 5 years of treatment with tamoxifen reduces the diagnosis of breast cancer in women at high risk for the disease by about 50%.² Its sister drug, raloxifene, is nearly as effective, reducing this risk by about 38%. The benefits of SERMs endure after 5 years, and serious side effects, such . . .