Tamoxofen as a preventative for high risk?

MMP

I am in a program where I am closely monitored due to family history (mammograms and breast MRIs alternating every six months).

It was mentioned that they want me to do five years of tamoxifen by the time I am 50.  I am 41.  Is this a good idea?  I don't mind taking it and enduring the side effects.  I am trying to find out if there are any negative findings associated with taking tamoxifen before I have been diagnosed---like it can cause cancer later on.................

Thanks for any input.

MMP

Thanks for the information.  I haven't had genetic testing yet.  I was told it was more helpful to do it after my sister has had it done (she was dx in 2006, my mother died of BC in 1994). So far, my sister has not done the genetic testing.

Beesie

Here's the website with best info that I've found on Tamoxifen:  http://www.rxlist.com/nolvadex-drug.htm#ad

If you click on any of the topics in the left hand column, there's lots of information in each of the sections.  Start on "Clinical Pharmacology" and if you scroll about 2/3 of the way down the page, you'll come to the section on "Reduction in Breast Cancer Incidence in High Risk Women", where it talks to the reduction in breast cancer occurrances for those who took Tamoxifen vs. those who did not in the NSABP P-1 Clinical Trial. Then if you click on "Side Effects" in the left hand column, on this page, again about 2/3 of the way down the page, you'll come to the section on "Reduction in Breast Cancer Incidence in High Risk Women" and here it details the side effects in high risk women who took Tamoxifen, again from the NSABP P-1 trial.

Hope that helps.

MMP

Thank you again.  My insurance is not a problem.  They just told me it is something I eventually want to have done, and I will.

Anonymous

MMP----are there other risk factors to consider other than your family history? any LCIS, ADH or ALH? anyone tested BRCA positive? I was diagnosed with LCIS (stage 0, non-invasive bc) and my risk is also elevated due to family history (mom had ILC), so I am very closely monitored with alternating MRIs and mammos every 6 months, and I just finished my 5 years of tamoxifen about 6 weeks ago. As much as I worry for my sisters, I don't think I would recommend that they go on tamox because of family history alone in the absence of a diagnosis.  But  it depends on your specific family history--if you have multiple primary relatives with bc (especially premenopausal) or a known positive BRCA gene, it might be a very good strategy for risk reduction. Tamoxifen is a very good preventative medication, but it  does have some serious SEs to take into consideration.(blood clots, endometrial cancer and cataracts, but these are rare SEs, generally less than 1% risk). It's generally well tolerated by most with the most common SE is hot flashes.

Anne

MMP

I think the only risk I have is that my mother was dx at 51, my sister at 41.  Also, I have never been pregnant.

I have a first cousin who had BC, but her mother (my mother's sister) is 80 and never had it. My cousin also has six sisters, all post menapausal, who never had it.

I think of the checklist the counselor went through, those were the only risks I have.  One doctor told my sister that since she had it in both breasts, it is highly likely it is genetic.  I don't know if that's true.

My risk at 39 y/o was 2%. It increased 2% each year---by the time I am 80 my risk will be at 33%.  If I have the gene, I am at 80% risk right now.  They didn't seem to rush me into having the genetic testing done, just said I may want to do it at some point. 

My fear is that tamoxifen will head off estrogen sensitive cancer, no doubt, but may put me at risk for some other form of very aggressive non estrogen related cancer and I will regret taking the tamoxifen.  I haven been able to find any research to support that, so maybe it is just in my head.  I thought a few years ago on this board someone had mentioned that tamoxifen may do this. 

I am aware of the side effects, but they beat the alternative. If side effects are the only con of taking this drug, I would be foolish not to. Just want to make sure I have all my facts.

Thanks again!

leaf

This paper seems to opine that tamoxifen may make estrogen negative cancer easier to detect. http://www.hopkinsbreastcenter.org/artemis/200811/18.html     http://www.ncbi.nlm.nih.gov/pubmed/18840821

Of course, most studies need repeating several times to make sure of the results.