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. 2014 Apr 2;110(7):1681-7.
doi: 10.1038/bjc.2014.109. Epub 2014 Mar 4.

Uptake of tamoxifen in consecutive premenopausal women under surveillance in a high-risk breast cancer clinic

L S Donnelly  1 , D G Evans  2 , J Wiseman  1 , J Fox  1 , R Greenhalgh  1 , J Affen  1 , I Juraskova  3 , P Stavrinos  4 , S Dawe  1 , J Cuzick  5 , A Howell  6
Affiliations

Uptake of tamoxifen in consecutive premenopausal women under surveillance in a high-risk breast cancer clinic

L S Donnelly et al. Br J Cancer. .

Abstract

Background: Randomised trials of tamoxifen versus placebo indicate that tamoxifen reduces breast cancer risk by approximately 33%, yet uptake is low. Approximately 10% of women in our clinic entered the IBIS-I prevention trial. We assess the uptake of tamoxifen in a consecutive series of premenopausal women not in a trial and explore the reasons for uptake through interviews.

Methods: All eligible women between 33 and 46 years at ≥17% lifetime risk of breast cancer and undergoing annual mammography in our service were invited to take a 5-year course of tamoxifen. Reasons for accepting (n=15) or declining (n=15) were explored using semi-structured interviews.

Results: Of 1279 eligible women, 136 (10.6%) decided to take tamoxifen. Women >40 years (74 out of 553 (13.4%)) and those at higher non-BRCA-associated risk were more likely to accept tamoxifen (129 out of 1109 (11.6%)). Interviews highlighted four themes surrounding decision making: perceived impact of side effects, the impact of others' experience on beliefs about tamoxifen, tamoxifen as a 'cancer drug', and daily reminder of cancer risk.

Conclusions: Tamoxifen uptake was similar to previously ascertained uptake in a randomised controlled trial (IBIS-I). Concerns were similar in women who did or did not accept tamoxifen. Decision making appeared to be embedded in the experience of significant others.

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Figures

Figure 1
Figure 1
Consort diagram showing total population approached and uptake of tamoxifen.
See this image and copyright information in PMC

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