The incidence of breast cancer has reached epidemic proportions in most Western developed countries. The breast cancer rate is three times higher than in developing countries. In the USA alone, one in eight women will develop breast cancer during her lifetime. Molecular medicine has allowed us to make great advances in understanding disease susceptibility and pathogenesis. It has also let us forge inroads into the genetic screening of women who have a family history of breast cancer. However, women who have been classified as members of the high-risk groups have expectations of effective prevention or prophylactic therapy that cannot, as yet, be delivered. It is time to give serious consideration to the emerging prophylactic strategies that take advantage of the advances in molecular techniques in order to address this deficit.