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Tamoxifen linked to tumour

Long term use of tamoxifen may quadruple risk of developing an uncommon but more aggressive form of cancer in the other breast

US research suggests that women with breast cancer who take tamoxifen long term may quadruple their risk of developing an uncommon but more aggressive form of the disease in the opposite breast, compared with women not treated with hormonal therapy.

The study conducted by the Fred Hutchinson Cancer Research Centre in Seattle (and published in Cancer Research) assessed tamoxifen use among more than 1,000 patients who were initially diagnosed with oestrogen receptor (ER)-positive invasive breast cancer between the ages of 40 and 79.

Results showed that compared with non-users of tamoxifen, women who underwent adjuvant treatment with tamoxifen for five years or more had a 440-per cent increased risk of ER-negative contralateral breast cancer. Tamoxifen use lasting less than five years was not associated with the increased risk.

The study also showed that long-term users of tamoxifen were 60 per cent less likely to develop an ER-positive tumour in the second breast, compared with women who did not receive the hormone therapy.

Christopher Li, lead investigator of the study said the results are "of concern, given the poorer prognoses of ER-negative tumours, which are also more difficult to treat." But that the benefits of Tamoxifen are "well established and doctors should continue to recommend hormonal therapy for breast cancer patients who can benefit from it."

Eric Winer, director of the breast oncology centre at the Dana-Farber Cancer Institute noted than tamoxifen "isn't being given to women to prevent cancer in the other breast; it's to prevent cancer from spreading to the bones, liver and the lungs. We know from other studies that, in this setting, tamoxifen is able to lower the chance the cancer will spread to other parts of the body and improve overall survival. 

Each year around 45,500 women in the UK are diagnosed with breast cancer and 12,000 die from the disease. Tamoxifen has been used to treat breast cancer for more than 20 years and has saved the lives of hundreds of thousands of women worldwide.

26th August 2009

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