BOSTON -- Researchers have found that due to concerns about risks and side effects, women at high risk for developing breast cancer are choosing not to take tamoxifen, the first and only drug approved by the U.S. Food and Drug Administration (FDA) for the prevention of breast cancer. The study appears in the December 14, 2004 issue of The Journal of Clinical Oncology.

"While the availability of tamoxifen is a significant advance in breast cancer prevention, it also presents a complicated decision for women at high risk for developing the disease," says the study's lead author Sharon Bober, PhD, staff psychologist at Beth Israel Deaconess Medical Center (BIDMC) and Dana-Farber Cancer Institute (DFCI) and Clinical Instructor in the Department of Psychiatry at Harvard Medical School.

"Our study underscores the need [for medical professionals] to address psychological factors that may influence decision-making, in order to help women feel confident and satisfied with their treatment choice."

Tamoxifen belongs to a class of drugs known as selective estrogen receptor modulators or SERMS, which work by preventing the hormone estrogen from binding to breast cancer cells, and thereby helping to halt the growth of these cancerous cells.

Prophylactic use of tamoxifen has been shown to reduce the risk of both invasive and non-invasive breast cancer by nearly 50 percent. However, tamoxifen also poses a number of risks and side effects: the risk of developing endometrial cancer, blood clots, and cataracts can increase with the use of tamoxifen, and menopausal symptoms such as hot flashes and night sweats can worsen.

Researchers at BIDMC evaluated both medical and psychological factors involved in decision making among 129 women who had a five-year risk of developing cancer of 1.7 percent or greater and were therefore deemed eligible to receive tamoxifen as a preventive measure. The subjects were counseled by their physicians about th
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14-Dec-2004

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