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Widely used breast cancer drug not linked to stroke

ein approached researchers at Kaiser Permanente Southern California, a large health maintenance organization with a vast number of women treated for breast cancer. Kaiser Permanente research scientist Ann M. Geiger, Ph.D., and biostatistician Wansu Chen, M.S., collaborated to conduct a nested case-control study among Los Angeles County women who were diagnosed with breast cancer between 1980 and 2000.

Out of 11,045 women in the Kaiser Permanente system who were diagnosed with breast cancer and who had not experienced a prior stroke, 179 women had a verifiable stroke in the years after treatment and were included in the study. Glenn M. Fischberg, M.D., assistant professor of neurology at the Keck School, examined patients' clinical medical records and brain scans to ensure patients had truly suffered strokes.

For their analysis, researchers matched each of the 179 women to two other stroke-free women who had been diagnosed with breast cancer at the same age and during the same year.

Researchers found that use of tamoxifen was not associated with risk of stroke, either overall or when grouped by duration of use, dose of the drug, or how recently the drug was used. However, use of chemotherapy-but not a specific chemotherapy regimen-was associated with a more-than-doubled risk of stroke, whether or not tamoxifen was used.

The investigators are unsure why chemotherapy might be linked to stroke risk.

Stroke was more common among women who had a history of hypertension or diabetes requiring medication.

"Our study suggests that women and their clinicians considering tamoxifen use for breast cancer treatment can do so without concern for stroke," the authors conclude.

Although the association between chemotherapy and stroke risk must be further explored, the researchers note that women with a history of chemotherapy "may benefit from approaches to reduce stroke risk
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Contact: Sarah Huoh
shuoh@usc.edu
323-442-2830
University of Southern California
19-Oct-2004


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