Re: Second Cancers After Adjuvant Tamoxifen Therapy for Breast Cancer

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Abstract
Curtis et al. ( 1 ) used the Surveillance, Epidemiology, and End Results (SEER) 1 Program data to evaluate the impact of tamoxifen therapy on the incidence of second primary tumors by comparing the rates of these tumors in patients with breast cancer who did and did not receive “ hormonal therapy” as part of their first course of cancer therapy. However, other hormones and steroids (which often accompany chemotherapy) are also included as hormonal therapy in the SEER data. Realizing these limitations, Curtis et al. ( 1 ) restricted their analyses to patients with breast cancer for whom the registry statement of hormone use would most likely represent tamoxifen use, i.e., women 50 years of age or older who had not received chemotherapy. We sought to determine if these restrictions improved the sensitivity and specificity of the SEER-recorded hormonal therapy in identifying patients with breast cancer who received tamoxifen by comparing SEER-recorded hormonal therapy with independently obtained data on tamoxifen use.

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