Is Tamoxifen Advertising a Public Service or a Public Nuisance?
Effective Clinical Practice, July/August 2000. In the March/April 2000 issue of ecp, Drs. Press and Burke write that “interim results from two European tamoxifen trials have not shown the substantial reduction in risk seen in the American trials.” (1) It is important to note that the British Royal Marsden Hospital trial was designed and initiated as a pilot feasibility trial. (2) Published results of this pilot trial are derived from an interim analysis at a median follow-up of 70 months. Participants were younger women who had a stronger family history of breast cancer, and 26% of the participants used hormone-replacement therapy concurrently with tamoxifen. It is not clear why the study produced negative results, but more of the British women may have been at greater risk for BRCA1 mutations and development of estrogen receptor-negative tumors that were not influenced by tamoxifen use. The Italian study enrolled a low-risk population of women, of whom 48% had bilateral prophylactic o
