Table of ContentsView AllTable of ContentsIndicationsBenefitsHow It WorksTamoxifen vs. AIsSide EffectsInteractions/ContraindicationsTreatment Duration
Table of ContentsView All
View All
Table of Contents
Indications
Benefits
How It Works
Tamoxifen vs. AIs
Side Effects
Interactions/Contraindications
Treatment Duration
Tamoxifen is a medication with both anti-estrogen andestrogen-like effects, depending on the particular type of tissue it affects. It is classified as a selective estrogen receptor modulator (SERM), along with the medication Evista (raloxifene).
This article will review the indications for tamoxifen, how it reduces the risk of breast cancer recurrence, what side effects can happen with the medication, and how it compares to aromatase inhibitors.
Daniel Grill/Getty Images
There are three primary uses for tamoxifen:
Tamoxifen isn’t usually beneficial for those who have estrogen- or progesterone-negative breast cancer.If your cancer is estrogen receptor- as well as HER2-positive, your healthcare provider may recommend tamoxifen (or an aromatase inhibitor), a HER2-targeted medication such as Herceptin, or both, depending on your specific situation.
Because the majority of breast cancers in men are estrogen receptor-positive, hormonal therapy is recommended for most male breast cancers.Tamoxifen is the hormonal therapy of choice in early-stage breast cancer (unless the medication is not tolerated or should not be used for some reason) per 2020 guidelines.This is in contrast to women, who have the option of tamoxifen or an aromatase inhibitor (for postmenopausal women or premenopausal women also treated with ovarian suppression therapy).
Tamoxifen comes in 10 milligrams and 20-milligram tablets, with the most common dose being 20 milligrams once a day.It is usually taken for five to 10 years or until a person switches to an aromatase inhibitor.
Tamoxifen Drug Interactions
Tamoxifen was approved in 1998 and has since been found effective in treating breast cancer for millions of people. It is still considered an excellent option if you are premenopausal or are postmenopausal and cannot take an aromatase inhibitor.
In contrast to its anti-estrogen effects on breast tissue, tamoxifen has estrogen-like effects on bone. Therefore tamoxifen (as well as Evista) may help slow or stop bone loss. Tamoxifen may also lower cholesterol levels, specifically LDL cholesterol.
Reduction of Late Recurrence
While many people associate surviving five years after breast cancer with a cure, this is far from true. In fact, for people who have estrogen-receptor-positive tumors, the cancer is more likely to recurafterfive years than in the first five years.
This is true even with very small, node-negative tumors. Fortunately, while chemotherapy does not appear to reduce the risk of late recurrences, tamoxifen does, and a 2019 study found that tamoxifen reduces the risk of recurrence up to 15 years after the initial diagnosis.
Late Recurrence of Breast Cancer
Anything that reduces the activity of CYP2D6 can result in a reduced amount of the active metabolite. Reduced activity of the enzyme may occur if you are taking other medications or if you have particular genetic variations that make the enzyme less active.
The Impact of Your Genetics
There is a spectrum of activity of the CYP2D6 enzyme, resulting in differences in the metabolism of drugs. A review of studies found that extensive metabolizers appear to have better outcomes than poor metabolizers.
There are commercial genotyping kit tests available for the genotyping of CYP2D6, but this testing is not ordinarily done for women on tamoxifen therapy for estrogen receptor-positive breast cancer. In other words, you probably won’t know if this issue applies to you.
This is an area of controversy as well, and some researchers believe that the presence of another enzyme, CYP3A4*22, might compensate for the reduction of endoxifen concentrations related to low CYP2D6 activity.
A 2019 study published in theJournal of Clinical Oncologymay be reassuring to those who wonder if they are poor metabolizers.In this study, the researchers found no association between CYP2D6 genotypes or endoxifen concentrations and the clinical outcomes of people with early-stage breast cancer who were treated with tamoxifen.
CYP2D6 ActivityIt’s worth noting that the activity of CYP2D6 tends to be higher in the summer months (it’s dependent on Vitamin D to some degree) and Vitamin D testing is important for women living with breast cancer.
CYP2D6 Activity
It’s worth noting that the activity of CYP2D6 tends to be higher in the summer months (it’s dependent on Vitamin D to some degree) and Vitamin D testing is important for women living with breast cancer.
Vitamin D May Reduce Breast Cancer Risk
Tamoxifen vs. Aromatase Inhibitors
Aromatase inhibitors are also used to prevent breast cancer recurrence.Drugs in this class include:
There are several differences between these drugs and tamoxifen, which dictate who can benefit from them and what risks they carry.
Effectiveness in Premenopausal Women
Estrogen and Ovaries
Risk of Recurrence
For women who are postmenopausal or those who are premenopausal and have received ovarian suppression therapy, an aromatase inhibitor may offergreater benefitsin reducing the risk of recurrence.This is one reason why oncologists may recommend switching to an aromatase inhibitor when you reach menopause or treating you with ovarian suppression therapy to induce menopause.
Bone Loss
Aromatase inhibitors also cause menopausal symptoms but can accelerate bone loss rather than reduce it like tamoxifen.Bone and joint pain can occur with either class of drugs but are much more common with aromatase inhibitors.
Cost
With respect to cost, tamoxifen therapy is usually much less expensive than any of the aromatase inhibitors.
Aromatase Inhibitors and Breast Cancer Recurrence
Many of the common side effects of tamoxifen are essentially the same as those that occur during menopause, when there is a reduced amount of estrogen in the body.
Common side effects of tamoxifen include:
Hot flashes are actually linked with better survival from breast cancer.
Risks
Tamoxifen’s actions on endometrial tissue can raise the risk ofuterine cancer. The risk is highest for postmenopausal women, but it is still rare. Premenopausal women treated with tamoxifen have no known increased risk of uterine cancer and require no additional monitoring beyond routine gynecologic care.
Tamoxifen can also increase your risk of developing blood clots either in your legs (deep vein thrombosis) or lungs (pulmonary embolism).
It’s important to call your healthcare provider if you have any symptoms you are concerned about, especially:Abnormal vaginal bleedingPain in your pelvisLeg pain and/or swellingChest painShortness of breathWeakness, numbness, or tinglingVision problems
It’s important to call your healthcare provider if you have any symptoms you are concerned about, especially:
Interactions and Contraindications
As with many medications, there are situations in which tamoxifen should not be used or where caution is needed.
Due to how it is metabolized, tamoxifen may interact with both some common prescription and over-the-counter medications.Talk to your healthcare provider about any other medications you use and make sure your pharmacist is aware as well. In particular, several antidepressants, as well as over-the-counter allergy medications, may reduce the effectiveness of tamoxifen.
Due to a relatively high rate of birth defects,tamoxifen should not be used in pregnancy, and the drug should be stopped at least two months before trying to get pregnant.
How Long You Should Take It
Based on clear evidence from two large randomized phase III clinical studies (ATLASand aTTom), a 10-year rather than a five-year adjuvant treatment with tamoxifen is associated with a smaller risk of recurrence and a reduction in breast cancer mortality.
This reduction in breast cancer recurrence must be weighed against potential side effects for each person. For example, if your cancer has a relatively high risk of recurrence (such as if lymph nodes are positive), the benefit of longer treatment may clearly outweigh the risk. In contrast, if your tumor has a very low risk of recurrence, the potential adverse effects of tamoxifen (such as blood clots) may outweigh the potential benefit.
For men with early-stage breast cancer, tamoxifen is recommended for five years, with the option of continuing the medication for another five years for those at high risk of recurrence.
Summary
Tamoxifen is an important medication that is used to reduce the risk of breast cancer recurrence in women who have estrogen receptor positive breast cancer. Although it does have the possibility of causing side effects such as hot flashes, or more seriously, blood clots, there can be significant benefit to reduce breast cancer risk.
A Word From Verywell
Tamoxifen can be a lifesaver for some women with breast cancer. As with all medications, however, there are potential risks and side effects. Working closely with your healthcare provider while you are on this drug will ensure you catch any problems that may arise.
Frequently Asked QuestionsNo, tamoxifen is not chemotherapy. Chemotherapy is medication that stops cells as they are dividing, whereas tamoxifen has activity with how hormones work in the body.Side effects, such as hot flashes, can start pretty quickly after starting tamoxifen. Some side effects, such as improving bone density, can take some time to be noticed.When you stop taking tamoxifen, as in stopping it before it is supposed to be discontinued, the risk for breast cancer recurrence can increase.
Frequently Asked Questions
No, tamoxifen is not chemotherapy. Chemotherapy is medication that stops cells as they are dividing, whereas tamoxifen has activity with how hormones work in the body.
Side effects, such as hot flashes, can start pretty quickly after starting tamoxifen. Some side effects, such as improving bone density, can take some time to be noticed.
When you stop taking tamoxifen, as in stopping it before it is supposed to be discontinued, the risk for breast cancer recurrence can increase.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Davies C, Pan H, Godwin J, et al.Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.Lancet. 2013;381(9869):805-816. doi:10.1016/S0140-6736(12)61963-1Cuzick J, Sestak I, Bonanni B, et al.Selective oestrogen receptor modulators in prevention of breast cancer: an updated meta-analysis of individual participant data.Lancet. 2013;381(9880):1827-1834. doi:10.1016/S0140-6736(13)60140-3Breastcancer.org.Tamoxifen (brand names: Nolvadex, Soltamox).Arpino G, Weiss H, Lee AV, et al.Estrogen receptor-positive, progesterone receptor-negative breast cancer: association with growth factor receptor expression and tamoxifen resistance.J Natl Cancer Inst. 2005;97(17):1254-1261. doi:10.1093/jnci/dji249Cardoso F, Bartlett JMS, Slaets L, et al.Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program.Ann Oncol. 2018;29(2):405-417. doi:10.1093/annonc/mdx651Hassett MJ, Somerfield MR, Baker ER, et al.Management of male breast cancer: ASCO guideline.Journal of Clinical Oncology.2020;38(16):1849-1863. doi:10.1200/JCO.19.03120FDA Access Data.Tamoxifen.Yu NY, Iftimi A, Yau C, et al.Assessment of long-term distant recurrence-free survival associated with tamoxifen therapy in postmenopausal patients with luminal a or luminal b breast cancer.JAMA Oncol. 2019;5(9):1304-1309. doi:10.1001/jamaoncol.2019.1856Sanchez-Spitman AB, Swen JJ, Dezentje VO, Moes DJAR, Gelderblom H, Guchelaar HJ.Clinical pharmacokinetics and pharmacogenetics of tamoxifen and endoxifen.Expert Rev Clin Pharmacol. 2019;12(6):523-536. doi:10.1080/17512433.2019.1610390Fleeman N, Martin Saborido C, Payne K, et al.The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review.Health Technol Assess. 2011;15(33):1-102. doi:10.3310/hta15330Breastcancer.org.Aromatase inhibitors.Early Breast Cancer Trialists’ Collaborative Group (EBCTCG).Aromatase inhibitors versus tamoxifen in premenopausal women with oestrogen receptor-positive early-stage breast cancer treated with ovarian suppression: a patient-level meta-analysis of 7030 women from four randomised trials.Lancet Oncol. 2022;23(3):382-392. doi:10.1016/S1470-2045(21)00758-0Hadji P, Aapro MS, Body JJ, et al.Management of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: joint position statement of the IOF, CABS, ECTS, IEG, ESCEO IMS, and SIOG.J Bone Oncol. 2017;7:1-12. doi:10.1016/j.jbo.2017.03.001Fontein DBY, Seynaeve C, Hadji P, et al.Specific adverse events predict survival benefit in patients treated with tamoxifen or aromatase inhibitors: an international tamoxifen exemestane adjuvant multinational trial analysis.J Clin Oncol. 2013;31(18):2257-2264. doi:10.1200/JCO.2012.45.3068American College of Obstetricians and Gynecologists. Committee Opinion.Tamoxifen and Uterine Cancer.Davies C, Pan H, Godwin J, et al.Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.The Lancet. 2013;381(9869):805-816.Gray RG, Rea D, Handley K, et al.Attom: long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer.JCO. 2013;31(18_suppl):5-5.Additional ReadingFleeman N, et al.The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review.Health Technol Assess.2011;15(33):1-102. doi:10.3310/hta15330National Cancer Institute.Breast cancer treatment (PDQ)—health professional version.Sahebkar A, Serban M, Penson P, et al.The effects of Tamoxifen on plasma lipoprotein(a) concentrations: systematic review and meta-analysis.Drugs. 2017;77(11):1187-1197. doi:10.1007/s40265-017-0767-4Sanchez-Spitman A, Dezentje V, Swen J, et al.Tamoxifen pharmacogenetics and metabolism: results from the Ppospective CYPTAM Study.Journal of Clinical Oncology.2019. doi:10.1200/JCO.18.00307Yu NY, Iftimi A, Yau C, et al.Assessment of long-term distant recurrence-free survival associated With Tamoxifen therapy in postmenopausal patients with luminal A or luminal B breast cancer.JAMA Oncology.2019. doi:10.1001/jamaoncol.2019.1856
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Davies C, Pan H, Godwin J, et al.Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.Lancet. 2013;381(9869):805-816. doi:10.1016/S0140-6736(12)61963-1Cuzick J, Sestak I, Bonanni B, et al.Selective oestrogen receptor modulators in prevention of breast cancer: an updated meta-analysis of individual participant data.Lancet. 2013;381(9880):1827-1834. doi:10.1016/S0140-6736(13)60140-3Breastcancer.org.Tamoxifen (brand names: Nolvadex, Soltamox).Arpino G, Weiss H, Lee AV, et al.Estrogen receptor-positive, progesterone receptor-negative breast cancer: association with growth factor receptor expression and tamoxifen resistance.J Natl Cancer Inst. 2005;97(17):1254-1261. doi:10.1093/jnci/dji249Cardoso F, Bartlett JMS, Slaets L, et al.Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program.Ann Oncol. 2018;29(2):405-417. doi:10.1093/annonc/mdx651Hassett MJ, Somerfield MR, Baker ER, et al.Management of male breast cancer: ASCO guideline.Journal of Clinical Oncology.2020;38(16):1849-1863. doi:10.1200/JCO.19.03120FDA Access Data.Tamoxifen.Yu NY, Iftimi A, Yau C, et al.Assessment of long-term distant recurrence-free survival associated with tamoxifen therapy in postmenopausal patients with luminal a or luminal b breast cancer.JAMA Oncol. 2019;5(9):1304-1309. doi:10.1001/jamaoncol.2019.1856Sanchez-Spitman AB, Swen JJ, Dezentje VO, Moes DJAR, Gelderblom H, Guchelaar HJ.Clinical pharmacokinetics and pharmacogenetics of tamoxifen and endoxifen.Expert Rev Clin Pharmacol. 2019;12(6):523-536. doi:10.1080/17512433.2019.1610390Fleeman N, Martin Saborido C, Payne K, et al.The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review.Health Technol Assess. 2011;15(33):1-102. doi:10.3310/hta15330Breastcancer.org.Aromatase inhibitors.Early Breast Cancer Trialists’ Collaborative Group (EBCTCG).Aromatase inhibitors versus tamoxifen in premenopausal women with oestrogen receptor-positive early-stage breast cancer treated with ovarian suppression: a patient-level meta-analysis of 7030 women from four randomised trials.Lancet Oncol. 2022;23(3):382-392. doi:10.1016/S1470-2045(21)00758-0Hadji P, Aapro MS, Body JJ, et al.Management of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: joint position statement of the IOF, CABS, ECTS, IEG, ESCEO IMS, and SIOG.J Bone Oncol. 2017;7:1-12. doi:10.1016/j.jbo.2017.03.001Fontein DBY, Seynaeve C, Hadji P, et al.Specific adverse events predict survival benefit in patients treated with tamoxifen or aromatase inhibitors: an international tamoxifen exemestane adjuvant multinational trial analysis.J Clin Oncol. 2013;31(18):2257-2264. doi:10.1200/JCO.2012.45.3068American College of Obstetricians and Gynecologists. Committee Opinion.Tamoxifen and Uterine Cancer.Davies C, Pan H, Godwin J, et al.Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.The Lancet. 2013;381(9869):805-816.Gray RG, Rea D, Handley K, et al.Attom: long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer.JCO. 2013;31(18_suppl):5-5.Additional ReadingFleeman N, et al.The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review.Health Technol Assess.2011;15(33):1-102. doi:10.3310/hta15330National Cancer Institute.Breast cancer treatment (PDQ)—health professional version.Sahebkar A, Serban M, Penson P, et al.The effects of Tamoxifen on plasma lipoprotein(a) concentrations: systematic review and meta-analysis.Drugs. 2017;77(11):1187-1197. doi:10.1007/s40265-017-0767-4Sanchez-Spitman A, Dezentje V, Swen J, et al.Tamoxifen pharmacogenetics and metabolism: results from the Ppospective CYPTAM Study.Journal of Clinical Oncology.2019. doi:10.1200/JCO.18.00307Yu NY, Iftimi A, Yau C, et al.Assessment of long-term distant recurrence-free survival associated With Tamoxifen therapy in postmenopausal patients with luminal A or luminal B breast cancer.JAMA Oncology.2019. doi:10.1001/jamaoncol.2019.1856
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Davies C, Pan H, Godwin J, et al.Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.Lancet. 2013;381(9869):805-816. doi:10.1016/S0140-6736(12)61963-1Cuzick J, Sestak I, Bonanni B, et al.Selective oestrogen receptor modulators in prevention of breast cancer: an updated meta-analysis of individual participant data.Lancet. 2013;381(9880):1827-1834. doi:10.1016/S0140-6736(13)60140-3Breastcancer.org.Tamoxifen (brand names: Nolvadex, Soltamox).Arpino G, Weiss H, Lee AV, et al.Estrogen receptor-positive, progesterone receptor-negative breast cancer: association with growth factor receptor expression and tamoxifen resistance.J Natl Cancer Inst. 2005;97(17):1254-1261. doi:10.1093/jnci/dji249Cardoso F, Bartlett JMS, Slaets L, et al.Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program.Ann Oncol. 2018;29(2):405-417. doi:10.1093/annonc/mdx651Hassett MJ, Somerfield MR, Baker ER, et al.Management of male breast cancer: ASCO guideline.Journal of Clinical Oncology.2020;38(16):1849-1863. doi:10.1200/JCO.19.03120FDA Access Data.Tamoxifen.Yu NY, Iftimi A, Yau C, et al.Assessment of long-term distant recurrence-free survival associated with tamoxifen therapy in postmenopausal patients with luminal a or luminal b breast cancer.JAMA Oncol. 2019;5(9):1304-1309. doi:10.1001/jamaoncol.2019.1856Sanchez-Spitman AB, Swen JJ, Dezentje VO, Moes DJAR, Gelderblom H, Guchelaar HJ.Clinical pharmacokinetics and pharmacogenetics of tamoxifen and endoxifen.Expert Rev Clin Pharmacol. 2019;12(6):523-536. doi:10.1080/17512433.2019.1610390Fleeman N, Martin Saborido C, Payne K, et al.The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review.Health Technol Assess. 2011;15(33):1-102. doi:10.3310/hta15330Breastcancer.org.Aromatase inhibitors.Early Breast Cancer Trialists’ Collaborative Group (EBCTCG).Aromatase inhibitors versus tamoxifen in premenopausal women with oestrogen receptor-positive early-stage breast cancer treated with ovarian suppression: a patient-level meta-analysis of 7030 women from four randomised trials.Lancet Oncol. 2022;23(3):382-392. doi:10.1016/S1470-2045(21)00758-0Hadji P, Aapro MS, Body JJ, et al.Management of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: joint position statement of the IOF, CABS, ECTS, IEG, ESCEO IMS, and SIOG.J Bone Oncol. 2017;7:1-12. doi:10.1016/j.jbo.2017.03.001Fontein DBY, Seynaeve C, Hadji P, et al.Specific adverse events predict survival benefit in patients treated with tamoxifen or aromatase inhibitors: an international tamoxifen exemestane adjuvant multinational trial analysis.J Clin Oncol. 2013;31(18):2257-2264. doi:10.1200/JCO.2012.45.3068American College of Obstetricians and Gynecologists. Committee Opinion.Tamoxifen and Uterine Cancer.Davies C, Pan H, Godwin J, et al.Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.The Lancet. 2013;381(9869):805-816.Gray RG, Rea D, Handley K, et al.Attom: long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer.JCO. 2013;31(18_suppl):5-5.
Davies C, Pan H, Godwin J, et al.Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.Lancet. 2013;381(9869):805-816. doi:10.1016/S0140-6736(12)61963-1
Cuzick J, Sestak I, Bonanni B, et al.Selective oestrogen receptor modulators in prevention of breast cancer: an updated meta-analysis of individual participant data.Lancet. 2013;381(9880):1827-1834. doi:10.1016/S0140-6736(13)60140-3
Breastcancer.org.Tamoxifen (brand names: Nolvadex, Soltamox).
Arpino G, Weiss H, Lee AV, et al.Estrogen receptor-positive, progesterone receptor-negative breast cancer: association with growth factor receptor expression and tamoxifen resistance.J Natl Cancer Inst. 2005;97(17):1254-1261. doi:10.1093/jnci/dji249
Cardoso F, Bartlett JMS, Slaets L, et al.Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program.Ann Oncol. 2018;29(2):405-417. doi:10.1093/annonc/mdx651
Hassett MJ, Somerfield MR, Baker ER, et al.Management of male breast cancer: ASCO guideline.Journal of Clinical Oncology.2020;38(16):1849-1863. doi:10.1200/JCO.19.03120
FDA Access Data.Tamoxifen.
Yu NY, Iftimi A, Yau C, et al.Assessment of long-term distant recurrence-free survival associated with tamoxifen therapy in postmenopausal patients with luminal a or luminal b breast cancer.JAMA Oncol. 2019;5(9):1304-1309. doi:10.1001/jamaoncol.2019.1856
Sanchez-Spitman AB, Swen JJ, Dezentje VO, Moes DJAR, Gelderblom H, Guchelaar HJ.Clinical pharmacokinetics and pharmacogenetics of tamoxifen and endoxifen.Expert Rev Clin Pharmacol. 2019;12(6):523-536. doi:10.1080/17512433.2019.1610390
Fleeman N, Martin Saborido C, Payne K, et al.The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review.Health Technol Assess. 2011;15(33):1-102. doi:10.3310/hta15330
Breastcancer.org.Aromatase inhibitors.
Early Breast Cancer Trialists’ Collaborative Group (EBCTCG).Aromatase inhibitors versus tamoxifen in premenopausal women with oestrogen receptor-positive early-stage breast cancer treated with ovarian suppression: a patient-level meta-analysis of 7030 women from four randomised trials.Lancet Oncol. 2022;23(3):382-392. doi:10.1016/S1470-2045(21)00758-0
Hadji P, Aapro MS, Body JJ, et al.Management of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: joint position statement of the IOF, CABS, ECTS, IEG, ESCEO IMS, and SIOG.J Bone Oncol. 2017;7:1-12. doi:10.1016/j.jbo.2017.03.001
Fontein DBY, Seynaeve C, Hadji P, et al.Specific adverse events predict survival benefit in patients treated with tamoxifen or aromatase inhibitors: an international tamoxifen exemestane adjuvant multinational trial analysis.J Clin Oncol. 2013;31(18):2257-2264. doi:10.1200/JCO.2012.45.3068
American College of Obstetricians and Gynecologists. Committee Opinion.Tamoxifen and Uterine Cancer.
Davies C, Pan H, Godwin J, et al.Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.The Lancet. 2013;381(9869):805-816.
Gray RG, Rea D, Handley K, et al.Attom: long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer.JCO. 2013;31(18_suppl):5-5.
Fleeman N, et al.The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review.Health Technol Assess.2011;15(33):1-102. doi:10.3310/hta15330National Cancer Institute.Breast cancer treatment (PDQ)—health professional version.Sahebkar A, Serban M, Penson P, et al.The effects of Tamoxifen on plasma lipoprotein(a) concentrations: systematic review and meta-analysis.Drugs. 2017;77(11):1187-1197. doi:10.1007/s40265-017-0767-4Sanchez-Spitman A, Dezentje V, Swen J, et al.Tamoxifen pharmacogenetics and metabolism: results from the Ppospective CYPTAM Study.Journal of Clinical Oncology.2019. doi:10.1200/JCO.18.00307Yu NY, Iftimi A, Yau C, et al.Assessment of long-term distant recurrence-free survival associated With Tamoxifen therapy in postmenopausal patients with luminal A or luminal B breast cancer.JAMA Oncology.2019. doi:10.1001/jamaoncol.2019.1856
Fleeman N, et al.The clinical effectiveness and cost-effectiveness of genotyping for CYP2D6 for the management of women with breast cancer treated with tamoxifen: a systematic review.Health Technol Assess.2011;15(33):1-102. doi:10.3310/hta15330
National Cancer Institute.Breast cancer treatment (PDQ)—health professional version.
Sahebkar A, Serban M, Penson P, et al.The effects of Tamoxifen on plasma lipoprotein(a) concentrations: systematic review and meta-analysis.Drugs. 2017;77(11):1187-1197. doi:10.1007/s40265-017-0767-4
Sanchez-Spitman A, Dezentje V, Swen J, et al.Tamoxifen pharmacogenetics and metabolism: results from the Ppospective CYPTAM Study.Journal of Clinical Oncology.2019. doi:10.1200/JCO.18.00307
Yu NY, Iftimi A, Yau C, et al.Assessment of long-term distant recurrence-free survival associated With Tamoxifen therapy in postmenopausal patients with luminal A or luminal B breast cancer.JAMA Oncology.2019. doi:10.1001/jamaoncol.2019.1856
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