Acceptance of Tamoxifen Chemoprevention by Physicians and Women at Risk

Julia Tchou, Nanjiang Hou, Alfred Rademaker, V. Craig Jordan, Monica Morrow*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

74 Scopus citations

Abstract

BACKGROUND. In the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 trial, tamoxifen was shown to reduce breast carcinoma risk by 49% in high-risk women. The purpose of the current study was to identify factors associated with being offered, and accepting, tamoxifen chemoprevention. METHODS. The records of 219 women who sought risk evaluation after the publication of the NSABP P-1 trial between September 1998 and October 2002 were reviewed. Risk was calculated using the model of either Gail et al. or Claus et al. The impact of individual risk factors on the offering and acceptance of tamoxifen was compared using the Fisher exact test and logistic regression analysis. RESULTS. Tamoxifen was offered to 137 women (63%) in the current study. The magnitude of Gail risk, age, menopausal status, hysterectomy, and history of lobular carcinoma in situ (LCIS) or atypical hyperplasia (AH) were all found to be significant predictors of a patient being offered tamoxifen. On multivariate analysis, only a history of AH or LCIS and hysterectomy were found to be significant, with odds ratios of 20.3 and 3.4, respectively. Fifty-seven of the women who were offered tamoxifen (42%) took the drug. Only a history of LCIS or AH and older age were found to be predictive of tamoxifen acceptance. CONCLUSIONS. In the current study, risk due to AH or LCIS was found to be the main predictor of being offered and accepting tamoxifen chemoprevention.

Original languageEnglish (US)
Pages (from-to)1800-1806
Number of pages7
JournalCancer
Volume100
Issue number9
DOIs
StatePublished - May 1 2004

Keywords

  • Atypical hyperplasia (AH)
  • Breast carcinoma risk
  • Lobular carcinoma in situ (LCIS)
  • Tamoxifen chemoprevention

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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