Very interesting article/origins of Tamoxifen~

Thanks, Timothy. While not perfect and not a 100% guarantee against recurrence or se's, you have to look at the risks vs. rewards. For many, many women it has been a game changer.

http://www.cancer.gov/newscenter/qa/2006/starresultsqandA

•  How many participants developed uterine cancer?
  In STAR, more than half of the women entered the trial having had a hysterectomy. Women without a uterus are not at risk of uterine cancer. For those women in the trial with a uterus, the women in the raloxifene group developed 45 percent fewer uterine cancers during the trial, a statistically significant reduction: 65 of 4,739 women in the tamoxifen group developed uterine cancers compared to 37 of the 4,717 women in the raloxifene group. Tamoxifen is known to increase a woman's chance of developing uterine cancer (mostly in the lining of the uterus or endometrium) by two to three times compared to a woman not taking the drug The annual incidence rate of uterine cancer is 2.25 per 1,000 women taking tamoxifen and 1.23 per 1,000 women taking raloxifene after almost 7 years. --

• How many participants developed blood clots?
  Both tamoxifen and raloxifene are known to increase a woman's chance of developing blood clots by up to three times that of women who are not taking either drug. In STAR, women in the raloxifene group had 28 percent fewer deep-vein thromboses (blood clots in a major vein) and 20 percent fewer pulmonary embolisms (blood clots in the lung) than women on tamoxifen: 118 of 9,736 women in the tamoxifen group had a deep-vein thrombosis compared to 86 of 9,754 women in the raloxifene group. In addition, 84 of 9,736 women in the tamoxifen group had a pulmonary embolism compared to 68 of 9,754 women in the raloxifene group. The average annual rate of either kind of blood clot was 3.3 per 1,000 women taking tamoxifen and 2.5 per 1,000 women taking raloxifene after almost 7 years.

Timothy et al,

It is easy to get blindsided when considering the pro's and the con's for any drug, since long-term usage on a wide basis is still minimal, and because reported cause of death still can be listed as due to diseases initiated by the use of a drug instead of being attributed to the drug. Because of that, I question the limited information about this drug even with its long history of use for breast cancer.

Here's why I think more questioning for the extended use of this drug is warranted:

1. The overwhelming majority of breast cancer patients are HR+, and tamoxifen is the drug of choice for any who are not completely menopausal, which includes some women into their late 50's/early 60's (whether or not they are still menstruating).

2. The overwhelming majority of breast cancers are diagnosed in women.

3. The overwhelming majority of breast cancer patients are diagnosed with bc over the age of 50.

4. Initial bc treatment often involves chemotherapy drugs that significantly impact the autoimmune system.

5. The S/S are not often attributed to the actual cause until later stages of development.

6. About 90% of those diagnosed with PBC are women.

Although PBC (primary biliary cirrhosis) is still evaluated as being a rare disease among the general population of women, the difficulty here is that this particular population is more vulnerable to it, and to having the S/S ignored until late for the best known treatment to be successful.

http://www.ojrd.com/content/3/1/1

A.A.

Joellelee,

I am questioning the steadily increasing length of treatment with tamoxifen.

I may have personally benefitted from the use of it, short-term.

Imaging during a very brief initial period of use may provide a basis for who benefits from taking it, or the degree to which there is any benefit, allowing those who do benefit from it to take it for a more limited period of time, or to avoid taking it for "nothing", and allowing women to avoid many SE's on a long-term basis:

See my post of March 30th in the hormonal treatment forum thread, "Is Anyone on a Half-dose of Tamoxifen."

A.A.

2012 Article about breast density as a way of measuring effectiveness of tamoxifen:

http://breast-cancer-research.com/content/14/4/R114

In addition, research has indicated that having a high AIB1 level is another indicator that tamoxifen may not be effective for HER2 positive patients in particular. I am not certain whether the actual testing for AIB1 is available for patient access at this point, or whether it is limited to use in clinical trials. I've seen it referred to as one form of IHC (immunohistochemistry) but it may be that additional testing of other types is required in addition to IHC, for more accuracy.