Tomoxifin as preventative medicine

[IrvineFriend]

I come from a long line of BC. Both Mom, Sister, Aunt, Great Aunt and myself have had the disease all premenopause. My younger sister found something and has MRI and ultrasound scheduled. Her doctor is suggesting she take Tomoxifin even if he finds her scans are clean. Has anyone heard of someone taking this who does NOT have BC, but has a long family history? Also, he said he could refer her for a double mastectomy for preventative measures if she would like to do that. She does not!

[roz123]

yes I have heard of tamox as a preventative
I know she said no to a prophy bi-lat msx, I understand that the thinking this is extremely drastic when there is no diagnosis, however going on tamox has its issues aswell. It is a heavy duty drug with many many SE - its tough for people who have had bc to stay on it
maybe she can opt for really aggressive screening (every 6mos) due to family history

['lizbeth]

There was this post earlier on the board:

http://www.news-medical.net/news/201...st-cancer.aspx

[AlaskaAngel]

Your family history and mine are pretty much the same.

Using tamoxifen as a preventative for those who are most likely to benefit from its use makes sense.

The question is, which patients get no clear benefit from tamoxifen, while still taking on any problems associated with it?

The link posted by 'lizbeth shows that some health care professionals are paying attention to such studies as those of the Karolinska Institute in regard to using breast cancer density to try to determine which patients benefit from tamoxifen. (Google Karolinska Institute and breast density and tamoxifen.)

I think I was one of those women who benefitted significantly from using tamoxifen. I also think that using the drug only short-term worked for me, for the very reasons outlined by the Karolinska Institute. If they are right, once repeat mammography shows that breast density has disappeared, the loss of density likely is an indicator that the tamoxifen has been effective and in that case, one likely wouldn't have to be on it long-term.

I was either pre or perimenopausal at time of diagnosis and did have chemotherapy and radiation first. And there is no way for me to know for certain whether taking tamoxifen alone before my cancer developed would have prevented my breast cancer.

But the key there is that my breast density did not change at all with chemotherapy or radiation. After I'd completed those therapies, my mammogram still showed dense breasts. However, within 3 months of being on tamoxifen, my breasts were extremely clear.

What I am saying is that maybe if your sister has repeat mammograms every 3 months, she could literally see whether she is someone who is benefitting from tamoxifen use or not. If her breasts continue to be dense, then perhaps some method of becoming at least temporarily menopausal might be another measure to use (along with the tamoxifen). If her breasts remain dense after both of those treatments, then perhaps the tamoxifen does not work for her and she could consider discontinuing it.

A.A.

[LeahM]

I was at a conference last night where they talked about this. The called it chemoprevention and said that women at a high risk of developing breast ca are often given Tamox as "risk reduction" measure. So I just wanted to chime in too and say that yep, I have heard of it.

[rachelhmmd]

Because both my mother AND my father had breast cancer, I took tamoxifen prophylactically for five years. I tolerated it well; perhaps the only side effect was a lighter menstrual period (who's complaining!). But, the year after I finished my course, I was diagnosed with breast cancer. Some of my docs called me a "tamoxifen failure," but my ever sunnysided oncologist said that perhaps I would have gotten it sooner, that it would have been more advanced, etc. I'm still glad I did it, because if I hadn't, and I developed cancer, I'd be kicking myself.

[IrvineFriend]

Hi Rachel, I'm curious. Was your cancer ER/PR positive? If so, what was the %? Breast cancer runs in my family big time and my relatives were ER/PR+. I had two types of cancer, one of which was ER/PR- (the predominant one) and the other had a very low ER/PR receptor number, like 8%. I saw a different Onc. today when I went in for Herceptin and he doesn't think I should be taking Tamox. at all because of increased risk of uterine cancer. Doesn't think the benefit outweighs the risk in my case because the majority of my cancer was the ER/PR- one. Anyone have thoughts on this? My Onc. is on vacation so he had someone overseeing chemo this week. Hate when they disagree, as it leaves me very confused! Personally, they can have my uterus, I don't really have a need for it.

Thanks everyone!!!!

-Julie

[rachelhmmd]

My cancer was ER+ (about 90%), PR-(<5%) and of course HER 2pos. I was not yet menopausal, and my oncologist even considered putting me back on tamoxifen, but I just lost confidence in it. So, after taxol/herceptin, I had my ovaries out and went on femara.

[linn65]

Hey there,

How old is your sister? I had the BRCA 1 & 2 test done. First, so my sisters would know if they should be tested. Second, whether I should remove my right breast too.