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TamoxifenFrom: ainsron@msn.comFri May 12 19:53:39 2000
I saw a returning patient today for the first time in five years. When I last saw her, she had a breast lump, difficult breast exam because of previous reduction mammoplasty and was hesitant to have a mammogram. She finally assented to it, the findings were suspicious and was referred to a surgeon; the biopsy was benign. Since that time she developed a new lump, referred herself back to the surgeon, it was positive, and she subsequently underwent a radical mastectomy one year ago for invasive breast cancer (I don't know what cell type), with positive nodes and she underwent chemo and radiation therapy. No evidence at this time of recurrence. One month ago she had a prophylactic mastectomy for the other breast, no disease was present on the pathology. She was placed on Tamoxifen after the first breast was removed. My question is: Does Tamoxifen have any benefit in breast cancer survivors who don't have a breast? My understanding of the purpose is to decrease risk of recurrence in the ipsilateral breast or the same breast if conservative surgery was used. The patient is concerned about the risks of tamoxifen, and brought up what she has read about endometrial cancer, blood clots, etc. I agreed that they were real, but relatively small. However, if there are now benefits, why take any risks? There is certainly benefits from bone protection, but is it worth it?
-- Ronald E. Ainsworth, MD
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