Abstract
BACKGROUND
In the National Surgical Adjuvant Breast and Bowel Project (NSABP) Pβ1 trial, tamoxifen was shown to reduce breast carcinoma risk by 49% in highβrisk women. The purpose of the current study was to identify factors associated with being offered, and accepting, tamoxifen chemoprevention.
METHODS
The records of 219 women who sought risk evaluation after the publication of the NSABP Pβ1 trial between September 1998 and October 2002 were reviewed. Risk was calculated using the model of either Gail et al. or Claus et al. The impact of individual risk factors on the offering and acceptance of tamoxifen was compared using the Fisher exact test and logistic regression analysis.
RESULTS
Tamoxifen was offered to 137 women (63%) in the current study. The magnitude of Gail risk, age, menopausal status, hysterectomy, and history of lobular carcinoma in situ (LCIS) or atypical hyperplasia (AH) were all found to be significant predictors of a patient being offered tamoxifen. On multivariate analysis, only a history of AH or LCIS and hysterectomy were found to be significant, with odds ratios of 20.3 and 3.4, respectively. Fiftyβseven of the women who were offered tamoxifen (42%) took the drug. Only a history of LCIS or AH and older age were found to be predictive of tamoxifen acceptance.
CONCLUSIONS
In the current study, risk due to AH or LCIS was found to be the main predictor of being offered and accepting tamoxifen chemoprevention. Cancer 2004. Β© 2004 American Cancer Society.