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Options for Extending Tamoxifen to Breast Cancer Patients

The Saskatchewan Cancer Agency will be offering early stage breast cancer patients the option of extending their adjuvant Tamoxifen use from 5 to 10 years based on the results from the recently published ATLAS trial. (Adjuvant Tamoxifen: Longer Against Shorter.) The Agency’s oncologists have reviewed the information from this study and believe the results to be clinically significant.

The study results showed:
• A reduction in the risk of breast cancer recurrence by an additional 3% (18% vs. 21%, RR 0.84, 95% CI 0.76-0.94)
• A reduction in breast cancer mortality by 2% (10 vs. 12%, p=0.01) and overall mortality by 3% (18 vs. 21%, p=0.01)
• A reduction in incidence of contralateral breast cancer by 2% (12% vs. 14%, p=0.05)

The study also showed some side effects that occurred more frequently with the extended treatment of Tamoxifen:
• A higher cumulative incidence of developing endometrial cancer by 1.5% (3.1% vs. 1.6%, p=0.0002)
• A higher incidence of pulmonary embolus by 0.6% (1.2% vs. 0.6%, p=0.01)
• A higher incidence of ischemic heart disease by 2% (4% vs. 2%, p=0.02)

The Cancer Agency is offering patients the opportunity to extend the planned Tamoxifen duration after further discussion with their family physician.

A letter has also been sent to all patients receiving Tamoxifen, and to their physicians. Patients have been asked to talk to their family physician about their options. After discussion between the patient and the family physician, the patient can choose to:
1. Continue a five-year treatment of Tamoxifen and then stop as originally planned
2. Continue Tamoxifen for a duration of 10 years under the direction of the family physician who is currently prescribing Tamoxifen and then stop
3. Be referred back to the Cancer Agency to see an oncologist to discuss the information in more detail

Physicians are asked to complete and fax back a form to the Cancer Agency the option for care the patient has chosen. Please contact the cancer centres if you have questions about this program:
• Allan Blair Cancer Centre (Regina): 306-766-2213
• Saskatoon Cancer Centre: 306-655-2662 


SCA Home | Professionals | Tamoxifen