Abstract
Women with a mutation in BRCA1 or BRCA2 face a lifetime risk of breast cancer of approximately 80 %. Tamoxifen treatment of the first cancer has been associated with a reduction in the risk of a subsequent contralateral cancer. We studied 1,504 women with a known BRCA1 or BRCA2 mutation, 411 women with bilateral breast cancer (cases) and 1,093 women with unilateral breast cancer (controls) in a matched case–control study. Control women were of similar age and had a similar age of diagnosis of first breast cancer as the cases. For each woman who used tamoxifen, the starting and stopping dates were abstracted and the duration of tamoxifen use was calculated. Three hundred and thirty-one women had used tamoxifen (22 %); of these 84 (25 %) had completed four or more years of tamoxifen, the remainder stopped prematurely or were current users. For women with up to 1 year of tamoxifen use, the odds ratio for contralateral breast cancer was 0.37 (95 % CI 0.20–0.69; p = 0.001) compared to women with no tamoxifen use. Among women with 1–4 years of tamoxifen use the odds ratio was 0.53 (95 % CI 0.32–0.87; p = 0.01). Among women with four or more years of tamoxifen use the odds ratio was 0.83 (95 % CI 0.44–1.55; p = 0.55). Short-term use of tamoxifen for chemoprevention in BRCA1 and BRCA2 mutation carriers may be as effective as a conventional 5-year course of treatment.
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Acknowledgements
We would like to thank study coordinators Adriana Valentini, Marcia Llacuachaqui, and Alejandra Ragone, as well as Jennifer Ng, Kristi De Buono, Kate Bisnaire, Dina Nikitina, Anneli Loo, Bita Khorram, Dina Gordon, Courtney May, Michelle Jones, Jose Miguel Lozano and Linda Steele who helped with the data collection and data entry. Supported by grants from the Canadian Breast Cancer Research Alliance and the Canadian Cancer Society Research Initiative and an ICARE grant IBG09-34198 awarded to T. Pal. SLN is the Morris and Horowitz Families Endowed Professor, and the work was supported by NIH R01 CA74415.
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Other members of the Hereditary Breast Cancer Clinical Study Group who contributed to the study: David Euhus, Judy Garber, Gad Rennert, Kevin Sweet, Ruth Gershoni-Baruch, Christine Rappaport, Edmond Lemire, Lovise Maehle, Dominique Stoppa-Lyonnet, Mary Daly, Sofia Merajver, Ava Kwong, Louise Bordeleau, Carey A. Cullinane, Eitan Friedman, Wendy McKinnon, Marie Wood, Daniel Rayson, Wendy Meschino, Jane McLennan, Josephine Wagner Costalas, Robert E. Reilly, Tuya Pal, Susan Vadaparampil, Kenneth Offit, Mark Robson, Noah Kauff, Jan Klijn, David Euhus, Claudine Isaacs, Fergus Couch, Cezary Cybulski, Tomasz Byrski, Ania Jakubowska, Seema Panchal, Sonia Nanda, Aletta Poll, Kelly Metcalfe, Barry Rosen, Susan Randall Armel, Albert Chudley, Gareth Evans, Joanne Blum, Beth Karlan, Dana Zakalik, John Lunn, Talia Donenberg, Barbara Pasini, Raluca N Kurz, Taya Fallen.
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Gronwald, J., Robidoux, A., Kim-Sing, C. et al. Duration of tamoxifen use and the risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. Breast Cancer Res Treat 146, 421–427 (2014). https://doi.org/10.1007/s10549-014-3026-3
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DOI: https://doi.org/10.1007/s10549-014-3026-3