It just keeps getting more complicated.
RB
http://www.emaxhealth.com/98/4753.html
Abstract
One of the most commonly administered drugs for breast cancer, tamoxifen, may not be as effective for women who inherit a common genetic change, according to researchers at Mayo Clinic and the University of Michigan. The genetic change affects the levels of a crucial liver enzyme, Cytochrome P4502D6, responsible for tamoxifen metabolism.
Up to 10 percent of Caucasian patients have an inherited genetic change that affects tamoxifen metabolism - and appear to be at higher risk of relapse while receiving tamoxifen.