Breast cancer chemoprevention: Risk-benefit effects of the antioestrogen tamoxifen

Karen Brown

Research output: Contribution to journalReview articlepeer-review

68 Scopus citations


The anti-oestrogen tamoxifen, which is widely used as adjuvant therapy for breast cancer, is undergoing evaluation as a chemopreventive agent in women at increased risk of developing this disease. Recent results from the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 prevention trial show a 49% reduction in breast cancer incidence in healthy, high-risk women. However, tamoxifen treatment has the serious side effect of increasing the incidence of endometrial cancer in women and long-term administration of tamoxifen causes hepatic tumours in rats. These liver tumours are induced via a genotoxic mechanism, but the mechanisms responsible for endometrial cancer in women are not yet known and are a focus of much debate. This review describes the findings from the chemoprevention trials and problems associated with the use of tamoxifen in this setting. The mechanism of carcinogenesis in rat liver is explained in detail and compared to the situation in humans, with a view to assessing the risks associated with tamoxifen therapy and predicting whether other anti-oestrogens might be safer alternatives.

Original languageEnglish
Pages (from-to)253-267
Number of pages15
JournalExpert Opinion on Drug Safety
Issue number3
StatePublished - 1 Sep 2002
Externally publishedYes


  • DNA adduct
  • breast cancer chemoprevention
  • endometrial cancer
  • tamoxifen
  • toremifene


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