First do no harm: extending the debate on the provision of preventive tamoxifen
2001

Preventive Tamoxifen for High-Risk Women

publication Evidence: moderate

Author Information

Author(s): Will B P, Nobrega K M, Berthelot J-M, Flanagan W, Wolfson M C, Logan D M, Evans W K

Primary Institution: The Health Analysis and Modeling Group, Statistics Canada

Hypothesis

What are the net health impacts of tamoxifen administration on high-risk Canadian women with no prior history of breast cancer?

Conclusion

Tamoxifen may be beneficial for women with a 5-year predicted risk of breast cancer of 3.32% or greater, but it does not increase life expectancy in this risk group.

Supporting Evidence

  • The Breast Cancer Prevention Trial showed tamoxifen could reduce breast cancer risk by 49%.
  • Tamoxifen can increase the risk of endometrial cancer, vascular events, and cataracts.
  • Predicted breast cancer risks at 5 years were calculated for women aged 35 to 70.

Takeaway

Tamoxifen can help some women avoid breast cancer, but it might not help them live longer and can cause other health issues.

Methodology

The study used a microsimulation model incorporating results from the Breast Cancer Prevention Trial.

Potential Biases

The views expressed may not represent those of the authors' organizations.

Limitations

The analysis is sensitive to the reduction in mortality observed in the BCPT-P-1 and other characteristics of the simulation model.

Participant Demographics

High-risk Canadian women aged 35 to 70 years.

Digital Object Identifier (DOI)

10.1054/bjoc.2001.2125

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