In the UK, the National Institute for Health and Care Excellence recommends the selective oestrogen receptor modulators (SERMs) tamoxifen and raloxifene for use in women at high risk of developing breast cancer, on the basis that they have been demonstrated to reduce the incidence of oestrogen-receptor positive tumours.12 However, evidence on the benefit of tamoxifen as a chemopreventive agent in BRCA1 mutation carriers is conflicting. The gene discussed is BRCA1; the disease is breast carcinoma.