Breast Cancer Research and Treatment

, Volume 146, Issue 2, pp 421–427 | Cite as

Duration of tamoxifen use and the risk of contralateral breast cancer in BRCA1 and BRCA2 mutation carriers

  • Jacek Gronwald
  • Andre Robidoux
  • Charmaine Kim-Sing
  • Nadine Tung
  • Henry T. Lynch
  • William D. Foulkes
  • Siranoush Manoukian
  • Peter Ainsworth
  • Susan L. Neuhausen
  • Rochelle Demsky
  • Andrea Eisen
  • Christian F. Singer
  • Howard Saal
  • Leigha Senter
  • Charis Eng
  • Jeffrey Weitzel
  • Pal Moller
  • Dawna M. Gilchrist
  • Olufunmilayo Olopade
  • Ophira Ginsburg
  • Ping Sun
  • Tomasz Huzarski
  • Jan Lubinski
  • Steven A. Narod
  • The Hereditary Breast Cancer Clinical Study Group
Epidemiology

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.

Keywords

Breast cancer Tamoxifen Oophorectomy BRCA1 BRCA2 

Notes

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.

Conflict of interest

The authors declare no conflicts of interest.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Jacek Gronwald
    • 1
  • Andre Robidoux
    • 2
  • Charmaine Kim-Sing
    • 3
  • Nadine Tung
    • 4
  • Henry T. Lynch
    • 5
  • William D. Foulkes
    • 6
  • Siranoush Manoukian
    • 7
  • Peter Ainsworth
    • 8
  • Susan L. Neuhausen
    • 9
  • Rochelle Demsky
    • 10
  • Andrea Eisen
    • 11
  • Christian F. Singer
    • 12
  • Howard Saal
    • 13
  • Leigha Senter
    • 14
  • Charis Eng
    • 15
  • Jeffrey Weitzel
    • 16
  • Pal Moller
    • 17
  • Dawna M. Gilchrist
    • 18
  • Olufunmilayo Olopade
    • 19
  • Ophira Ginsburg
    • 20
    • 21
  • Ping Sun
    • 21
  • Tomasz Huzarski
    • 1
  • Jan Lubinski
    • 1
  • Steven A. Narod
    • 21
  • The Hereditary Breast Cancer Clinical Study Group
  1. 1.Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
  2. 2.Epidemiology Research UnitResearch Center of the University of Montreal Hospital Centre (CRCHUM)MontrealCanada
  3. 3.BC Cancer AgencyVancouverCanada
  4. 4.Beth Israel Deaconess HospitalBostonUSA
  5. 5.Department of Preventive Medicine and Public HealthCreighton University School of MedicineOmahaUSA
  6. 6.Programs in Cancer Genetics, Department of Oncology and Human GeneticsMcGill UniversityMontrealCanada
  7. 7.Istituto Nazionale de TumoriMilanItaly
  8. 8.London Regional Cancer ProgramLondonCanada
  9. 9.Department of Population SciencesBeckman Research Institute of City of HopeDuarteUSA
  10. 10.Division of Gynecologic Oncology, Department of Obstetrics and GynecologyUniversity of TorontoTorontoCanada
  11. 11.Sunnybrook Regional Cancer CenterTorontoCanada
  12. 12.Department of Obstetrics and Gynecology and Comprehensive Cancer CenterMedical University of ViennaViennaAustria
  13. 13.Division of Medical GeneticsChildren’s Hospital Medical CenterCincinnatiUSA
  14. 14.Division of Human Genetics, Comprehensive Cancer CenterThe Ohio State University Medical CenterColumbusUSA
  15. 15.Genomic Medicine Institute, Center for Personalized Genetic HealthcareCleveland ClinicClevelandUSA
  16. 16.Division of Clinical Cancer GeneticsCity of Hope Medical CenterDuarteUSA
  17. 17.Norwegian Radium InstituteOsloNorway
  18. 18.Department of Medicine GeneticsUniversity of AlbertaEdmontonCanada
  19. 19.University of ChicagoChicagoUSA
  20. 20.Department of MedicineUniversity of TorontoTorontoCanada
  21. 21.Women’s College Research InstituteTorontoCanada

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