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" ... 3. This study shouldn’t inform care after bilateral mastectomy. That’s because the only clear, non-toxic finding was a reduction in contralateral cancers. This point should be clarified for physicians, including internists and other doctors, and nurse practitioners, who might prescribe this drug five or ten or more years after a breast cancer diagnosis, as happens increasingly in survivorship clinics. And it should be explained to patients who are considering an extended course of this drug. ... "
" ... I am in no way prepared to say that women who receive CPM are making poor choices. For starters, breast cancer diagnoses are usually very traumatic experiences. If CPM reduced contralateral cancers, even without increasing long-term survival, many women might find that benefit large enough to justify the procedure, so they can avoid undergoing a second round of diagnoses and treatments. Moreover many women in the midst of deciding upon a mastectomy to treat their primary breast cancers may perceive a second mastectomy as a much less invasive procedure than it would be down the road, as a stand alone procedure, should they receive a second diagnosis. ... "