Tamoxifen prophylaxis

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    Tamoxifen prophylaxis


    A comment on this article appears in "Does tamoxifen prophylaxis for breast cancer provide long-term prevention? We report an updated analysis of IBIS-I that focuses on the period after active treatment was completed, a time for which little evidence from other trials is available. A comment on this article appears in "Tamoxifen: an enduring star." J Natl Cancer Inst. Initial results from the first International Breast Cancer Intervention Study (IBIS-I) found that tamoxifen reduced the risk of invasive estrogen receptor (ER)-positive tumors by 31% in women at increased risk for breast cancer, but most of the follow-up at this time was during the active treatment phase. A total of 7145 women who were aged 35-70 years and at increased risk of breast cancer were randomly assigned to receive either tamoxifen (20 mg/day) or placebo for 5 years. The primary outcome measure was the incidence of breast cancer (including ductal carcinoma in situ), but side effects were also investigated. Relative risks were computed as the ratio of incidence rates. After a median follow-up of 96 months after randomization, 142 breast cancers were diagnosed in the 3579 women in the tamoxifen group and 195 in the 3575 women in the placebo group (4.97 versus 6. woman-years, respectively; risk ratio [RR] = 0.73, 95% confidence interval [CI] = 0.58 to 0.91, P = .004). The prophylactic effect of tamoxifen was fairly constant for the entire follow-up period, and no diminution of benefit was observed for up to 10 years after randomization. However, side effects in the tamoxifen group were much lower after completion of the active treatment period than during active treatment. Tamoxifen and raloxifene are the only FDA-approved drugs for breast cancer risk reduction in women at higher than average risk. You may also hear the term “chemoprevention” to describe these drugs, but they are not chemotherapy drugs. Tamoxifen and raloxifene only reduce the risk of estrogen receptor-positive breast cancers. Tamoxifen is a hormone therapy drug used to both treat and prevent breast cancer. Neither drug reduces the risk of estrogen receptor-negative cancers [215]. Tamoxifen is more effective than raloxifene in lowering breast cancer risk (tamoxifen lowers risk by about 50 percent and raloxifene by about 38 percent) in women at high risk [215]. However, raloxifene has fewer harmful side effects than tamoxifen (see table below) [215]. This makes raloxifene a better choice for some women. Tamoxifen and raloxifene have some long-term side effects (see table below) and may not be right for all women at higher than average risk.

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    Jnci. JNCI Articles 273 and the impact in the 5 years following active treatment is impor-tant in assessing overall benefit. Apr 17, 2006. Learn about the Study of Tamoxifen and Raloxifene STAR clinical trial, which is comparing the drug raloxifene Evista® with the drug. Bernardo Bonanni gained his medical degree in 1985 from the University of Pisa, Italy. Currently, Dr Bonanni is Co-Director of the Division of Cancer.

    "Nearly 90% of women at risk of breast cancer shun preventative drugs due to fear of side effects and 'fate'," reports the Independent Online. Current guidelines recommend that women thought to be at increased risk of developing breast cancer because they have a family history of the condition should be offered a drug called tamoxifen. Tamoxifen can reduce this risk, but the drug, which women usually have to take every day for 5 years, can cause side effects such as hot flushes, tiredness and nausea. A new study looked at 258 higher-risk women who had been recommended tamoxifen and referred to a specialist centre in England. The researchers found only around 1 in 7 women (14.7%) decided to take tamoxifen. Of the 258 women, 16 agreed to take part in follow-up interviews explaining the reasons why they did or didn't decide to use tamoxifen. The researchers found women with children were more likely to agree to treatment. Recommendations made by the USPSTF are independent of the U. It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U. For women who are at increased risk for breast cancer and at low risk for adverse medication effects, clinicians should offer to prescribe risk-reducing medications, such as tamoxifen or raloxifene. The USPSTF recommends that clinicians engage in shared, informed decision making with women who are at increased risk for breast cancer about medications to reduce their risk. The USPSTF does not consider the costs of providing a service in this assessment. The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms..

    Tamoxifen prophylaxis

    New Guidelines on Chemoprevention for Breast Cancer - Medscape, The Study of Tamoxifen and Raloxifene STAR Questions and.

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  5. Jun 25, 2013. If you are at high risk and you haven't yet had the menopause, you should be offered a drug called tamoxifen if appropriate. If you're at high risk.

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    A Randomized Trial Comparing Tamoxifen Therapy vs. Tamoxifen Prophylaxis in Bicalutamide-Induced Gynecomastia Imperial Cancer Research Fund Cancer Epidemiology Unit, Radcliffe Infirmary, Oxford OX2 6HE, United Kingdom Initial results from the first International Breast Cancer Intervention Study IBIS-I found that tamoxifen reduced the risk of invasive estrogen receptor ER-positive.

     
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