Re: Weighing the Risks and Benefits of Tamoxifen Treatment for Preventing Breast Cancer

Extract

In April 1998, the Breast Cancer Prevention Trial (P-1) was halted 14 months early because of a 45% reduction in breast cancer among those patients receiving tamoxifen. At that time, all of the major networks and newspapers made a lead story out of the National Cancer Institute's announcement of this finding. Many of the media reports repeated the investigators' contention that the trial's entry criteria identified women who are potentially eligible for tamoxifen therapy, e.g., all women over the age of 60 years (1).

Now, 1½ years later, the Journal has published a special article entitled “Weighing the Risks and Benefits of Tamoxifen Treatment for Preventing Breast Cancer” (2). Its authors assessed the data from the Breast Cancer Prevention Trial P-1 (3) and estimate that the benefits of taking tamoxifen substantially outweigh the risks only for younger high-risk women; conversely, the risks might outweigh the benefits for most black women older than 60 years of age and most white women older than 60 years with a uterus. In other words, tamoxifen therapy is an appropriate consideration for a much smaller subset of high-risk women than was originally thought.