Tamoxifen for breast cancer prevention: a framework for clinical decisions

Obstetrics and Gynecology
Samuel CykertCharles Hansen

Abstract

Given the potential side effects and an uncertain survival benefit, decisions about tamoxifen treatment for the primary prevention of breast cancer remain complex. Primary care providers, including gynecologists, will need to counsel patients regarding this form of preventive care. In this report, we update cost-effectiveness calculations for tamoxifen chemoprevention and establish reasonable parameters for clinicians' use. We performed a cost-effectiveness analysis that compared women aged 50 years who were treated with tamoxifen for 5 years with an untreated cohort. In the base model, we assumed a 3.4% 5-year breast cancer risk. Quality-of-life estimates for important outcomes (breast cancer, endometrial cancer, deep venous thrombosis, pulmonary embolism, stroke, metastatic cancer, and hot flushes) were obtained from 106 women. Probabilities and costs of outcomes were derived from the Breast Cancer Chemoprevention Trial and other published estimates. Broad sensitivity analyses were performed. Cost per quality-adjusted life-year gained as a result of tamoxifen breast cancer prevention was the main outcome measure. The use of tamoxifen led to a remaining life expectancy of 26.07 quality-adjusted life-years compared with 25.97 w...Continue Reading

References

Feb 1, 1990·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·H PourquierH Pujol
May 1, 1995·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·C A QuietS Hellman
Jun 1, 1996·American Journal of Obstetrics and Gynecology·N M SpirtosS C Ballon
Sep 1, 1996·Stroke; a Journal of Cerebral Circulation·T N TaylorM F Jacobson
Jan 1, 1997·Journal of the American Medical Informatics Association : JAMIA·L A Lenert, R M Soetikno
Apr 8, 1998·Archives of Internal Medicine·E J van BeekJ W ten Cate
May 22, 1998·Integrative Physiological and Behavioral Science : the Official Journal of the Pavlovian Society·S Wolf
Aug 26, 1998·Journal of the American Geriatrics Society·B BreuerR Anderson
Nov 5, 1999·Journal of the National Cancer Institute·M H GailV Vogel
Jan 19, 2000·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·T J Smith, B E Hillner
Apr 14, 2000·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·B P WillW K Evans
Nov 14, 2000·Archives of Internal Medicine·G de LissovoyS V Sorensen
Mar 22, 2001·Journal of the National Cancer Institute·H J StewartA P Forrest
Jun 30, 2001·The New England Journal of Medicine·C L Shapiro, A Recht
Jan 5, 2002·Journal of the National Cancer Institute·Patricia A GanzThomas R Belin
Feb 16, 2002·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·A N TostesonL J Melton
Apr 12, 2002·Lancet·U VeronesiUNKNOWN Italian Tamoxifen Study Group
Jun 7, 2002·Lancet·Steven R Cummings, L Joseph Melton
Jun 19, 2002·JAMA : the Journal of the American Medical Association·Lisa M Schwartz, Steven Woloshin
Jul 3, 2002·Annals of Internal Medicine·UNKNOWN U.S. Preventive Services Task Force
Jul 19, 2002·JAMA : the Journal of the American Medical Association·Jacques E RossouwUNKNOWN Writing Group for the Women's Health Initiative Investigators
Apr 3, 2003·Journal of the National Cancer Institute·Andrew N FreedmanMitchell H Gail

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Citations

Jul 6, 2006·Breast Cancer Research and Treatment·Khalid El OuagariJane Brandman
Apr 19, 2007·BMC Women's Health·Eric S MeadowsJoseph A Johnston
Feb 13, 2016·Health Technology Assessment : HTA·Robert C SteinUNKNOWN OPTIMA Trial Management Group
Jan 21, 2016·Cancer Chemotherapy and Pharmacology·Fangxuan LiJuntian Liu
Aug 19, 2009·European Journal of Cancer Care·P BlahaG Steger
Mar 1, 2016·Expert Review of Pharmacoeconomics & Outcomes Research·Amy G Groom, Tallal Younis
Feb 4, 2014·American Journal of Obstetrics and Gynecology·Kevin M WymerBeth A Plunkett
Jul 12, 2011·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·H E CampbellM J Sculpher
Sep 2, 2014·Thrombosis Research·Kerstin HoggPhil Wells
Jul 26, 2006·Cancer·Joy MelnikowJames Nuovo
Sep 2, 2004·Obstetrics and Gynecology·Dwight J Rouse
Oct 19, 2010·Expert Review of Pharmacoeconomics & Outcomes Research·Tessa PeasgoodJohn Brazier
Nov 18, 2006·The Oncologist·Edith A Perez

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