Tamoxifen does not increase survival?

CAMommy

I keep reading how tamoxifen decreases the risk of recurrence of both DCIS and IDC after having DCIS as well as reducing the risk of a new BC in the opposite breast. However I have read study after study that tamoxifen does not increase overall survival of DCIS patients (I believe it does increase survival for higher staged BC). So why take it if it doesn't decrease mortality?

I have my bottle of it ready to go after rads, but I'm questioning it.... Yes it reduces recurrence, but it does not increase survival.

Annette47

The other issue to consider is that while Tamoxifen reduces the risk of recurrence, it may very well be that the vast majority of recurrences are caught early enough that mortality is not affected .... but the patients still have to go through surgery, radiation, and perhaps even chemo to survive. This is why lumpectomy/radiation and mastectomy have similar survival rates but there is a higher chance of recurrence with lumpectomy - the recurrences are not necessarily fatal. While the number of recurrences which may eventually be fatal may be small enough that the risk isn’t noticeably raised, it could still happen (just to be clear).

It’s one of my pet peeves that mortality is often the only metric looked at when while of course it’s the most important there are other things to consider as well. Personally, I am not at particularly high risk for Tamoxifen side effects, and have been tolerating it well for over 2 years so I would prefer to reduce my risk of having to go through this again ... even if going through it again would be survivable. For people having a tougher time with Tamoxifen, they might make different choices.

ballet12

Hi Annette, you make a good point... about the possibility of going through treatment again. If one is prepared for that possibility, then maybe the reoccurrence risk isn't so bad. That's the way I see it for myself. If one only had "pure" DCIS, I think that one might look at it differently than if one had microinvasion or greater invasion in Stage 1A. My chances of a recurrence being IDC are about 6 percent based on the MSKCC nomogram (of course no one knows for sure)

CAMommy

I'll take it because I'm risk adverse, and because it offers me some protections that I lost by giving up estrogen patch such as increased bone density and reduced cardiac risk but if the side effects are too much, I'm not opposed to stopping it.

I know part of the issue is DCIS has such a high survival rate it's hard to improve upon almost 100%.