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The Pros and Cons of Tamoxifen For Breast Cancer

Preventive Medication Has Value But Potentially Serious Side Effects

Aug 1, 2008

Weighing the Pros and Cons, Michelle Kwajafa

Tamoxifen is proven to prevent breast cancer. But it may cause side effects ranging from unpleasant to life threatening. Each woman must balance those risks and benefits.

For those women who have had estrogen receptor positive breast cancer, tamoxifen has been a valuable tool in preventing the recurrence of tumors. Women who are at higher risk for developing breast cancer will need to balance their risk against the potential side effects of this cancer medication.

Who is at Risk for Breast Cancer?

Women that have close relatives-mother, sisters, daughters- who have been diagnosed with breast cancer
Women who have a history of breast abnormalities, especially ductal or lobular carcinoma in situ
Women who began menstruation before the age of 12 and/or began menopause after 55
Women over 50 years old
Obese and inactive women
Women using oral contraceptives with high levels of estrogen and progesterone in them

The National Cancer Institute website has a personal risk assessment tool to help each woman determine her risk level.

The Benefits of Tamoxifen

Tamoxifen has been used for more than 30 years and there is growing evidence of its value, especially for women who have been treated for estrogen receptor positive breast cancer, as it significantly reduces the incidence of tumor recurrence.

Cancer research, including the Breast Cancer Prevention Trial, has shown that Tamoxifen use resulted in a significant reduction in the risk of developing hormone sensitive breast cancer. The study followed women who were at increased risk of developing breast cancer for 7 years. Tamoxifen was also more effective than raloxifene in preventing non-invasive breast cancers. It is also considered to be the drug of choice for premenopausal women. As an added benefit, tamoxifen reduces the risk of hip, spine and some hand fractures in postmenopausal women, as it helps prevent osteoporosis.

The Risks Associated with Tamoxifen

The most common minor side effects include hot flashes or night sweats, changes in menses, fatigue and painful joints. Less common but also minor side effects such as fluid retention, weight gain, headaches, depression or mood changes, rashes, thinning hair, vaginal discharge or dryness and itching affect some women.

Tamoxifen increases the risk of osteoporosis in premenopausal women, the opposite of the effect it has on postmenopausal women. It may be harmful to a developing fetus so it is not recommended during pregnancy. Cataracts, corneal scarring and retinal changes have also been reported.

Although they are more uncommon, there are some serious potential side effects that need to be considered such as increased risk of strokes or blood clots.

And, while tamoxifen protects against estrogen dependent breast cancer, it may increase the risk of developing two other types of cancer, uterine sarcoma and endometrial cancer, in women who have not had a hysterectomy.

Women who have had breast cancer or are at increased risk for this disease should discuss the risks and benefits of tamoxifen with their doctor to determine the best course of action in their personal situation.

The copyright of the article The Pros and Cons of Tamoxifen For Breast Cancer in Breast Health is owned by Dawn M. Smith. Permission to republish The Pros and Cons of Tamoxifen For Breast Cancer in print or online must be granted by the author in writing.