Acceptance of tamoxifen chemoprevention by physicians and women at risk
- 22 March 2004
- Vol. 100 (9) , 1800-1806
- https://doi.org/10.1002/cncr.20205
Abstract
In the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 trial, tamoxifen was shown to reduce breast carcinoma risk by 49% in high-risk women. The purpose of the current study was to identify factors associated with being offered, and accepting, tamoxifen chemoprevention. The records of 219 women who sought risk evaluation after the publication of the NSABP P-1 trial between September 1998 and October 2002 were reviewed. Risk was calculated using the model of either Gail et al. or Claus et al. The impact of individual risk factors on the offering and acceptance of tamoxifen was compared using the Fisher exact test and logistic regression analysis. Tamoxifen was offered to 137 women (63%) in the current study. The magnitude of Gail risk, age, menopausal status, hysterectomy, and history of lobular carcinoma in situ (LCIS) or atypical hyperplasia (AH) were all found to be significant predictors of a patient being offered tamoxifen. On multivariate analysis, only a history of AH or LCIS and hysterectomy were found to be significant, with odds ratios of 20.3 and 3.4, respectively. Fifty-seven of the women who were offered tamoxifen (42%) took the drug. Only a history of LCIS or AH and older age were found to be predictive of tamoxifen acceptance. In the current study, risk due to AH or LCIS was found to be the main predictor of being offered and accepting tamoxifen chemoprevention.Keywords
This publication has 27 references indexed in Scilit:
- Overview of the main outcomes in breast-cancer prevention trialsThe Lancet, 2003
- Patient Reluctance Toward Tamoxifen Use for Breast Cancer Primary PreventionAnnals of Surgical Oncology, 2001
- Interim analysis of the incidence of breast cancer in the Royal Marsden Hospital tamoxifen randomised chemoprevention trialThe Lancet, 1998
- Prevention of breast cancer with tamoxifen: preliminary findings from the Italian randomised trial among hysterectomised womenThe Lancet, 1998
- Predictors of and Satisfaction with Bilateral Prophylactic MastectomyPreventive Medicine, 1995
- Projecting Individualized Probabilities of Developing Breast Cancer for White Females Who Are Being Examined AnnuallyJNCI Journal of the National Cancer Institute, 1989
- A Randomized Clinical Trial Evaluating Tamoxifen in the Treatment of Patients with Node-Negative Breast Cancer Who Have Estrogen-Receptor–Positive TumorsNew England Journal of Medicine, 1989
- TAMOXIFEN AND CONTRALATERAL BREAST CANCERThe Lancet, 1985
- Risk Factors for Breast Cancer in Women with Proliferative Breast DiseaseNew England Journal of Medicine, 1985
- Effect of tamoxifen (ICI 46,474) on initiation and growth of DMBA-induced rat mammary carcinomataPublished by Elsevier ,1976