AHRQ Breast Cancer Task Force Recommends Limiting Tamoxifen Use to Women at High Risk
The U.S. Preventive Services Task Force yesterday recommended that only women at high risk of developing breast cancer should take treatments such as tamoxifen to reduce their chances of developing the disease, USA Today reports. The panel also recommended that doctors discuss with women the benefits and risks of taking such treatments as a preventive measure (Rubin, USA Today, 7/2). The task force, sponsored by the Agency for Healthcare Research and Quality, reviewed three randomized controlled studies of tamoxifen, the only medication that the FDA has approved to reduce the risk of breast cancer in high-risk women. The task force found "fair evidence" that the treatment can reduce breast cancer risk by 50% in women at high risk -- those older than age 40 with a family history of breast cancer or a history of atypical cells on a breast biopsy. In addition, the task force reviewed one study of the off-label use of raloxifene, an osteoporosis treatment, as a preventive breast cancer treatment and found "consistent evidence" that the medication reduced the risk of the disease (AHRQ release, 7/1). However, tamoxifen use can lead to an increased risk of uterine cancer and blood clots in the legs and lungs. Therefore, the panel said that the "benefits outweigh the harm only in certain groups" of high-risk women:
- Women ages 40 to 49 who do not have a predisposition to blood clots; and
- Women ages 50 to 59 who do not have a predisposition to blood clots and do not have a uterus.