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The concurrent use of tamoxifen with drugs that are combined CYP3A4/ABCB1 inhibitors, therefore, could theoretically either inhibit or enhance tamoxifen efficacy, because they might, (1) reduce endoxifen levels, since CYP3A4 is involved along with CYP2D6 in the formation of endoxifen, (2) reduce endoxifen efflux from breast cancer cells through inhibition of ABCB1 (and perhaps ABCC2), (3) counteract the detrimental effect of any CYP3A4/ABCB1 inducers the patient might be taking

In contrast, subcutaneous fat lies directly beneath the epidermis and can be felt and seen with the naked eye

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These three turn Pre into a complete system

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