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Tamoxifen Pill Not Cost Effective For Most High Risk Breast Cancer Patients - Extends Life For Women With 3% Chance Who Take Drug

July 23rd 2006

Tamoxifen Pill Not Cost Effective For Most High Risk Breast Cancer Patients - Extends Life For Women With 3% Chance Who Take Drug

Tamoxifen Binds To Estrogen Receptor

Researchers in the U.S. and Canada say that most women, even when they are at a very high risk for breast cancer, can not increase their life expectancy by taking the cancer drug tamoxifen.  Tamoxifen was approved by the Food and Drug Administration in 1998 for breast cancer prevention in women who have at least a 1.67-percent chance of developing the disease over the next five years.

The prevention strategy is expensive, according to the researchers.  It costs $1.3 million per year for each life saved.  Joy Melnikow said, "We found that for women at the lower end of the high-risk range for developing breast cancer, there is a very small likelihood that taking tamoxifen will reduce mortality.  This would support revising the current recommended risk threshold for physicians to counsel women about tamoxifen."  Joy is the lead author of the study and professor of family and community medicine at UC Davis School of Medicine and Medical Center.


It has been shown that tamoxifen can reduce the incidence of invasive breast cancer among high-risk women by up to 49 percent.  But there are side effects, including cataracts requiring surgery, deep vein thromboses, endometrial cancer and stroke. 

If a patient that uses tamoxifen for prevention does develop breast cancer, it is usually the estrogen receptor-negative tumor, which has a worse prognosis.  The researchers say that tamoxifen usually prevents the estrogen receptor-positive cancer.

The team, which was made up of researchers from UC Davis, UC San Francisco, the University of Pittsburgh and McMaster University in Ontario, Canada, says that it can extend the life expectancy for women with a 3 percent (or more) chance of developing breast cancer in the next five years.  This is especially true for women who “have not had a hysterectomy, and therefore face the risk of endometrial cancer related to tamoxifen use”.


The researchers were mostly looking at the cost effectiveness of taking tamoxifen for prevention.  They compared the risk to the annual flu shot which costs about $980 per year of life saved for patients ages 65 and older.  A colonoscopy every 10 years costs about $11,000 per year of life saved for people 50 and older and annual mammography costs about $58,000 per year of life saved for women ages 40 to 80.  

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Copyright 2005 Best Syndication                   Last Updated Saturday, July 10, 2010 09:46 PM