In a nutshell
This study investigated the use of low dose tamoxifen (nolvadex) on tumor recurrence when given as a post surgical treatment for ductal intraepithelial neoplasia.
Some background
Breast cancer cells which have not yet broken through the tissue layer in which they reside are often called intraepithelial, and are considered to be non-invasive. Ductal intraepithelial neoplasia (DIN) refers to such a cancer that has developed within the ducts of the breast. Treatment of these non-invasive tumors is generally surgical, by removing only the area of the tumor (a lumpectomy), or removing the entire breast (mastectomy).
Some breast cancer cells express estrogen receptors (surface structures that respond to estrogen hormone). Tamoxifen binds to the estrogen receptors, preventing estrogen from binding to them, which would stimulate tumor growth. Tamoxifen is a common treatment for estrogen receptor positive (ER+) invasive breast cancers. However, the benefit of estrogen targeted drugs in the treatment of DIN is still under debate.
Methods & findings
This study investigated the use of tamoxifen among patients with ER+ DIN and treated with surgery. 474 patients were treated with low dose tamoxifen after surgery, and were followed for up to 7 years. The rate of cancer recurrence was compared to a control group of 509 similar patients who did not receive additional tamoxifen after surgery.
Patients treated with tamoxifen had a 30% reduction in the risk of cancer recurrence compared to the control group. This effect was mainly observed in postmenopausal women.
The bottom line
In conclusion, this study showed for the first time that low-dose tamoxifen is a safe and effective treatment for ER+ intraepithelial breast cancer patients as well as invasive cancer patients, and may reduce the risk of cancer recurrence.
The fine print
During this study treatment doses varied, and other treatments received (such as radiotherapy) were not taken into account. These variations were a result of changes in treatment recommendations over the time span of this study.
What’s next?
Consult with your physician regarding low dose tamoxifen treatment after surgery.
Published By :
Annals of oncology
Date :
Jul 01, 2013
