Tamoxifen Protects Certain Women at High Risk for Breast Cancer

Those who've undergone ovarian removal are shielded from estrogen-linked disease, study finds

By Amanda Gardner
HealthDay Reporter

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WEDNESDAY, May 2 (HealthDay News) -- Tamoxifen helps prevent breast cancer in women at high risk for the disease who have also had their ovaries removed as part of a hysterectomy, researchers report.

The new study, "reaffirms that tamoxifen is still a tremendous drug for prevention of breast cancer in women who are at a high risk for development of the disease," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. He was not involved in the trial.

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The study -- an extended follow-up of the Italian Randomized Tamoxifen Trial -- is published in the May 2 issue of the Journal of the National Cancer Institute.

The initial findings of the trial found tamoxifen offered no reduction in women's risk for breast cancer. Nor had some other European trials, some of which looked at women with different risk profiles.

But an earlier and much larger study, the National Surgical Adjuvant Breast and Bowel Project (NSABP) Breast Cancer Prevention Trial, had shown that tamoxifen could cut the risk of estrogen-receptor-positive breast cancer -- tumors that grow in the presence of estrogen. In fact, that trial was halted early, because the risk reduction in invasive breast cancer was so striking.

Here, the authors presented 11-year follow-up data on more than 5,400 women who had undergone a hysterectomy (including having both ovaries removed) and who had been randomly assigned to receive tamoxifen or a placebo for five years.

Ovaries make estrogen, so removing them ensures that no extra estrogen -- which can fuel some breast cancer tumors -- is being produced.

For women at low risk for breast cancer, disease rates were similar whether or not they took tamoxifen, the researchers reported.

The situation was different for higher-risk women. In that case, women taking tamoxifen had lower rates of hormone-receptor-positive breast cancer than those taking a placebo: 1.5 per 1,000 women-years in the tamoxifen group versus 6.26 per 1,000 women-years in the placebo group.

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