© 1991 by Oxford University Press
Journal of the National Cancer Institute, Vol. 83, No. 20, 1450-1459,
October 16, 1991
© 1991 Oxford University Press
Potential Role of Tamoxifen in Prevention of Breast Cancer
Community Oncology and Rehabilitation Branch, Division of Cancer Prevention and Control, National Cancer Institute Bethesda, Md.
Office of the Director, National Cancer Institute Bethesda, Md.
Clinical Investigations Branch, Division of Cancer Treatment, National Cancer Institute Bethesda, Md.
*Correspondence to: Susan G. Nayfield, M.D., Executive Plaza North, Rm. 300, National Institutes of Health, Bethesda, MD 20892.
Despite advances in early detection and treatment of breast cancer, primary prevention has not been well explored, especially for women at increased risk of disease due to reproductive factors and family history. There are, however, suggestions that primary prevention of breast cancer may be a realistic objective. Randomized clinical trials of adjuvant therapy for early-stage breast cancer have demonstrated a 35% decrease in contralateral breast cancers among women receiving tamoxifen compared with controls, suggesting a potential role for tamoxifen in chemoprevention of breast cancer in women at increased risk of the disease. Adjuvant therapy studies also demonstrate that tamoxifen is well tolerated by most patients and suggest additional health benefits from alterations in plasma lipid levels and stabilization of bone mineral loss in women receiving tamoxifen. Aspects of tamoxifen pharmacology, laboratory research, and clinical experience which support its investigation as a chemopreventive agent for breast cancer are summarized, and potential toxic effects are discussed. [J Natl Cancer Inst 83: 1450–1459, 1991]
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