Word: breast
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...didn't take long for the backlash to begin. Breast-cancer support groups weighed in almost at once. Why, they asked, would an otherwise healthy woman want to take a drug that can cause birth defects, trigger blood clots and double her chance of getting cancer of the uterus? Some questioned the drug's value even for the 29 million American women whose chances of getting breast cancer are, like Helene Wilson's, significantly higher than the 1-in-9 national average. Tamoxifen is already approved as a breast-cancer treatment, so physicians can prescribe it for prevention as well...
...those demands in the late 1980s that made University of Pittsburgh surgeon Dr. Bernard Fisher and others take a second look at tamoxifen, which had been in use for a decade as a milder alternative to chemotherapy for treating breast cancer. They noticed that it not only helped keep cancer from returning in the affected breast but also cut in half the number of new cancers in the other breast. Animal studies suggested that tamoxifen latches on to receptors in breast-cancer cells that would ordinarily take up the hormone estrogen--a substance known to fuel the growth of cancer...
That being the case, Fisher and other researchers wondered whether this cell-starvation process could prevent breast cancer from taking hold in the first place. Thus in 1992 they began the federally funded, 13,388-participant, $50 million study of women at especially high risk; being over 60 was a qualification by itself. Participants could also be included if they had a combination of two or more close relatives who had had the disease, a first child late in life, and several previous biopsies of suspicious lumps...
Researchers knew--and made clear to participants going in--that the drug was not without danger. While tamoxifen acts as an estrogen blocker in the breast, it acts more like estrogen itself in other parts of the body. That's why the scientists were on the lookout for uterine cancer and effects on the circulatory system. And while such problems did show up, so did the hoped-for protection. Women who took the tamoxifen had a 45% lower incidence of breast malignancies than those who took placebos. Results were so dramatic that the scientists stopped the study and gave...
Whether the women in the study group--or any other women at high risk for breast cancer--should take tamoxifen is complicated not only by the potential side effects but also by another confusing trade-off. Tamoxifen causes the most serious side effects in women over 50. But those are the women who have the highest odds of getting breast cancer. So many factors have to be weighed in the choice that researchers plan to produce a chart or software that will help women decide what to do. Unfortunately, it won't be ready for at least three months...