Home' Trinidad and Tobago Guardian : August 20th 2013 Contents said he frequently prescribes tamoxifen to prevent breast
cancer among women with BRCA1 or BRCA2 mutations
who do not choose to have their breasts removed.
"I ve been recommending tamoxifen in that sense for
many years to prevent breast cancer," Narod, who did
not take part in the new study, told Reuters Health.
"Very few doctors do. I think that this paper gives
some pretty good support for the position that we should
be using tamoxifen to prevent breast cancer in BRCA1
and BRCA2 carriers." (Reuters)
body & soul
Guardian www.guardian.co.tt Tuesday, August 20, 2013
Taking tamoxifen is tied to a sharply reduced risk
of a second breast cancer among women who carry
the BRCA1 or BRCA2 "breast cancer genes," new
Women with mutations of those genes are much
more likely to develop breast and ovarian cancer than
other women. Some---like Angelina Jolie---will opt to
have their breasts removed preemptively, which reduces
breast cancer risk by more than 95 per cent.
Other women may choose to have their ovaries
removed, which cuts breast cancer risk in half. The
new findings suggest taking tamoxifen may be another
breast-cancer-preventing option for those women,
whether or not they have already had cancer once,
"In light of our finding, women with a BRCA1 or
BRCA2 mutation should review their cancer risk
management options with their specialist clinician,"
Dr Kelly-Anne Phillips of the Peter MacCallum Cancer
Centre in Victoria, Australia, the study s lead author,
told Reuters Health.
Many breast cancer patients have tumours that
grow and spread when exposed to estrogen. Women
with these hormone-responsive cancers are typically
prescribed tamoxifen, which blocks estrogen and
reduces their risk of cancer recurrence by 40 per
But women with breast cancer who have BRCA1
or BRCA2 gene mutations are not typically offered
"There were very few BRCA1 and BRCA2 mutation
carriers in previous studies of tamoxifen for breast
cancer prevention, so there has been inadequate infor-
mation about whether tamoxifen is useful in that
specific group of women," Phillips said in an email.
To investigate whether the drug might help these
high-risk women, Phillips and her colleagues analysed
the results of three studies including a total of 1,583
BRCA1 mutation carriers and 881 BRCA2 carriers who
had developed cancer in one breast. Twenty-four per
cent of the BRCA1 carriers and 52 per cent of the
BRCA2 carriers began taking tamoxifen after being
During an average of eight years of follow-up, 520
women---24 per cent of the BRCA1 carriers and 17
percent of the BRCA2 carriers---developed cancer in
the opposite breast.
Women with the BRCA1 mutation were 62 percent
less likely to develop a second cancer if they took
tamoxifen, while BRCA2 carriers had a 67 percent
lower risk with the drug. Tamoxifen was tied to fewer
second cancers whether or not women s original
tumors had been estrogen-responsive, according to
findings published in the Journal of Clinical Oncol-
"Our study suggests tamoxifen should now be con-
sidered for all BRCA1 and BRCA2 mutation carriers
who have had breast cancer... if they have chosen
not to have all their breast tissue removed," Phillips
Preventing first cancers
Women who carry the BRCA1 or BRCA2 mutation
who have not developed breast cancer may want to
consider taking tamoxifen as well, Phillips added.
"For BRCA1 and BRCA2 mutation carriers, tamox-
ifen should be considered while they are young and
pre-menopausal because these women are at risk of
breast cancer at an early age," she said.
The American Society of Clinical Oncology says
a five-year course of tamoxifen should be discussed
for women age 35 and older at increased risk of breast
"The most common side-effect is menopausal
symptoms such as hot flushes," Phillips said. "Most
women find these tolerable but many women like to
make a plan to try tamoxifen for a month or two to
see how it feels, before finalising a plan to use it for
the recommended five years."
Generic tamoxifen can be bought for about $100
per month or less.
Dr Steven Narod, a professor at the Women s
College Research Institute at the University of Toronto,
YOUR DAILY HEALTH
News and advice
Many breast cancer
tumors that grow
and spread when
exposed to estrogen.
Drug cuts second breast cancer risk
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