Should women take 10 years of tamoxifen to prevent breast cancer recurrence?


At this year's San Antonio Breast Cancer Symposium, a long-term study of tamoxifen was announced. This study, called ATLAS, looked at women who took more than five years of tamoxifen after breast cancer. There has been a lot of interest in whether more than five years of tamoxifen is beneficial in reducing the risk of recurrence or breast cancer death and this study helped answer that question.

It showed that there is a 3 percent drop in mortality rate and about a 3-4 percent drop in recurrence rate. And it didn't become apparent until 10 years after randomization. It's a delayed effect.

But this is good news. It means we do have another tool for longer-term therapy that can further lower the risk of recurrence, but it mostly pertains to women who are still premenopausal (otherwise we would use a new class of drugs called aromatase inhibitors).

So, now when women hit the five-year mark of tamoxifen, they should check with their doctors to see if more hormonal therapy might be indicated in their case.

Watch Dr. Tripathy's full opinion about the ATLAS study below.



What about the risk of injury to the eyes or the risk of endometrial cancer if taken for 10 years? I thought the reason the 5 years was first suggested was because of these risks. I took Tamoxifin for 3 years and developed endometrial cancer requiring a hysterectomy. I was taken off Tamoxifin after that time. AIs were not considered because I already had significant joint pain from arthritis. Again and again, researchers are more interested in just the cancer and not the side effects of these drugs which can be horrendous.
- Posted by Dana Isherwood 12/14/12 12:00 AM

My breast cancer was diagnosed in 1999. Surgical biopsy and wide excision were done, my margins were still not clear. I decided to have a mastectomy followed by another surgery for reconstruction. My treatment was Tamoxifen for five years. During this time I experienced joint pain and weight gain, but thought this was better than another possible bout with breast cancer. My treatment concluded five years later, and I prayed "that was that". My joint pain, for the most part subsided. What did continue was, of all things, toe pain. One toe. Off to the podiatrist I went and was told I needed orthotics. Four hundred dollars later and numerous unsuccessful modifications left me without relief. Soon I was unable to walk the three miles a day I was enjoying. Itgot worse. I couldn't sleep with covers on my toes. The pain was agonizing. On my scheduled visit to my PCP,routine bloodwork showed my blood glucose was 215 ! I had never had a value more than 87 in my life ! I had subsequent nerve conduction studies on my hands and feet, along with other testing. I was now the "proud owner" of a polyneuropathy which has gotten worse and worse over the years, despite a very well controlled diabetes. In 2009 I was diagnosed with uterine cancer and had a complete hysterectomy. I knew full well that this was also a possibility with Tamoxifen. My life has changed. I am still thankful every day and night for being alive and my many blessings. Would I take Tamoxifen again if I had a "do over" ? I don't know. I have definitely adapted to a different lifestyle and thank God for having survived two cancers. I'm a "tough broad" and will fight forever, but I just fon't know if I would ever take Tamoxifen again, and certainly not for ten years.
- Posted by Carol 12/18/12 8:29 PM


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