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Tamoxifen Cuts Risk of Contralateral Breast Cancer.
Tamoxifen treatment for up to 4 years appeared to cut the risk of contralateral breast cancer in women with a mutation in their BRCA1 or BRCA2 genes and a history of the disease, a recent study suggests.
The study, a retrospective, case-control analysis of 593 women, represents the first time that the effect of tamoxifen on the risk of breast cancer caused by BRCA1 and BRCA2 mutations has been estimated, and it left clinical experts divided in their conclusions.
"These data support the hypothesis that there is no biological difference in the efficacy of tamoxifen in breast cancers with and without BRCA1 and BRCA2 mutations," commented Dr. Gabriel N. Hortobagyi, chairman of the department of breast and medical oncology at the M.D. Anderson Cancer Center in Houston.
"There is reason to consider tamoxifen chemoprevention for women with BRCA1 and BRCA2 mutations in view of their risk category," he commented in an interview with this newspaper.
But a skeptical view was taken by Dr. Lynn C. Hartmann, a medical oncologist from the Mayo Clinic in Rochester, Minn., who specializes in breast cancer management.
The current, standard duration of tamoxifen therapy for preventing breast cancer is 5 years; when treatment lasted at least that long in the new study, the risk of breast cancer increased.
In addition, a majority of breast cancers found in women with BRCA1 mutations are negative for estrogen receptors, and the results from prior studies indicated that tamoxifen was not beneficial when used to treat women with estrogen receptor-negative tumors. "For breast cancer prevention, this study does not convince me that tamoxifen is effective for BRCA1 and BRCA2 carriers," Dr. Hartmann told this newspaper.
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