nolvadex benefits for male We downgraded the certainty of the evidence from moderate to very low GRADE downgrading factor risk of bias the analysis of interest was a secondary objective and included only a subgroup of participants women still at risk after two years of therapy, therefore data on women included in the subgroup analysis are not reported; results by individual endocrine therapy are not reported; there was no adjustment for important confounding factors such as age, body mass index, baseline density, time between mammograms, and chemotherapy