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Tamoxifen's clinical applications: old and new.

A U Buzdar1

  • 1Department of Breast Medical Oncology, M. D. Anderson Cancer Center, Houston, TX 77037, USA. abuzdar@mdanderson.org

Archives of Family Medicine
|October 14, 2000
PubMed
Summary

Tamoxifen citrate significantly reduced invasive breast cancer risk by 49% in high-risk women. However, potential risks like uterine cancer necessitate careful patient counseling before initiating this preventive therapy.

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Area of Science:

  • Oncology
  • Preventive Medicine
  • Pharmacology

Background:

  • Breast cancer affects over 180,000 US women annually, with over 40,000 deaths.
  • Tamoxifen citrate is a medication used for breast cancer treatment and prevention.

Purpose of the Study:

  • To evaluate the efficacy of tamoxifen citrate in reducing breast cancer risk.
  • To identify specific patient subgroups that may benefit most from tamoxifen therapy.

Main Methods:

  • A National Cancer Institute model was used to assess the impact of 5-year tamoxifen citrate therapy.
  • Risk reduction was analyzed in women with increased breast cancer risk, including those with a history of lobular carcinoma in situ (LCIS) or atypical hyperplasia.

Main Results:

  • Tamoxifen citrate reduced invasive breast cancer risk by 49% (P<.00001) in high-risk women.
  • Greater risk reductions were observed in women with a history of LCIS (56%) and atypical hyperplasia (86%).
  • Two European studies with different methodologies found no significant benefit.

Conclusions:

  • Tamoxifen citrate demonstrates significant potential in reducing breast cancer risk for specific high-risk populations.
  • Elevated risks of uterine cancer and thromboembolic disease associated with tamoxifen require thorough patient counseling.
  • Individualized risk-benefit assessment is crucial for women considering tamoxifen for breast cancer prevention.

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