Raloxifene (Evista) is currently being studied in a large randomized study comparing it to tamoxifen for prevention of breast cancer in postmenopausal women. Information on this study is available at (604) 822-7997. It is not approved or proven for use in women with a history of breast cancer, nor is it approved for prevention. The osteoporosis study [ 30] suggested a 76% decrease in the rate of breast cancer in a group of women who were not at high risk. However, this study was in older women, had very small numbers, was not planned to have breast cancer as a primary endpoint, and needs confirmation. Both raloxifene and tamoxifen can cause hot flushes and dyspareunia, and are not appropriate to treat these menopausal symptoms. Both drugs are effective in improving heart and bone outcomes, and raloxifene is licensed for use in osteoporosis. We are all waiting for the perfect SERM that will prevent osteoporosis, cardiac disease, Alzheimer’s, and breast cancer, relieve hot flushes, vaginal complaints, and depression, and not increase the risk of thromboembolic events or uterine cancer. Unfortunately that SERM is not yet available.