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. 2008 Apr;108(3):421-6.
doi: 10.1007/s10549-007-9612-x. Epub 2007 May 31.

Tamoxifen, hot flashes and recurrence in breast cancer

Joanne E Mortimer  1 , Shirley W Flatt, Barbara A Parker, Ellen B Gold, Linda Wasserman, Loki Natarajan, John P Pierce; WHEL Study Group
Collaborators, Affiliations

Tamoxifen, hot flashes and recurrence in breast cancer

Joanne E Mortimer et al. Breast Cancer Res Treat. 2008 Apr.

Abstract

We utilized data from the comparison group of the Women's Healthy Eating and Living randomized trial to investigate an "a priori" hypothesis suggested by CYP2D6 studies that hot flashes may be an independent predictor of tamoxifen efficacy. A total of 1551 women with early stage breast cancer were enrolled and randomized to the comparison group of the WHEL multi-institutional trial between 1995 and 2000. Their primary breast cancer diagnoses were between 1991 and 2000. At study entry, 864 (56%) of these women were taking tamoxifen, and hot flashes were reported by 674 (78%). After 7.3 years of follow-up, 127 of those who took tamoxifen at baseline had a confirmed breast cancer recurrence. Women who reported hot flashes at baseline were less likely to develop recurrent breast cancer than those who did not report hot flashes (12.9% vs 21%, P = 0.01). Hot flashes were a stronger predictor of breast cancer specific outcome than age, hormone receptor status, or even the difference in the stage of the cancer at diagnosis (Stage I versus Stage II). These findings suggest an association between side effects, efficacy, and tamoxifen metabolism. The strength of this finding suggests that further study of the relationship between hot flashes and breast cancer progression is warranted. Additional work is warranted to clarify the mechanism of hot flashes in this setting.

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Figures

Fig. 1
Fig. 1
Kaplan–Meier recurrence-free survival as a function of reported hot flashes in all tamoxifen users
Fig. 2
Fig. 2
Recurrence-free survival as a function of hot flashes in tamoxifen users, age <50 years
Fig. 3
Fig. 3
Recurrence-free survival as a function of hot flashes in tamoxifen, age ≥50 years
See this image and copyright information in PMC

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