Weighing the risks and benefits of tamoxifen treatment for preventing breast cancer
Weighing the risks and benefits of tamoxifen treatment for preventing breast cancer
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DOI：
10.1093/jnci/91.21.1829
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发表时间：
1999-11-03
期刊：
影响因子：
--
通讯作者：
Vogel, V
中科院分区：
文献类型：
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作者：
Gail, MH;Costantino, JP;Vogel, V
背景资料：为了响应乳腺癌预防试验的结果，即他莫昔芬治疗使高风险妇女患浸润性乳腺癌的风险降低了49%，国家癌症研究所于1998年7月7日和8日主办了一次研讨会，以开发信息来帮助咨询和权衡他莫昔芬的风险和益处，我们的研究是为了开发工具，以确定妇女的利益大于风险，方法：信息进行了审查的发病率浸润性乳腺癌和原位病变，以及其他几个健康的结果，在没有他莫昔芬治疗。还审查了他莫昔芬对这些结局影响的数据，并开发了比较他莫昔芬风险和获益的方法，结果：他莫昔芬的风险和益处取决于年龄和种族，以及女性乳腺癌的特定风险因素，特别是，他莫昔芬的子宫内膜癌，中风，肺栓塞和深静脉血栓形成的绝对风险随年龄增加而增加，这些绝对风险在白色和黑人妇女之间是不同的，三苯氧胺对骨折的保护作用也是如此。表格和艾滋病的发展，以描述的风险和利益的他莫昔芬，并确定类妇女的利益大于风险。结论：他莫昔芬对乳腺癌风险升高的年轻女性最有益。所提出的定量分析可以帮助卫生保健提供者和妇女权衡他莫昔芬降低乳腺癌风险的风险和益处。
Background: In response to findings from the Breast Cancer Prevention Trial that tamoxifen treatment produced a 49% reduction in the risk of invasive breast cancer in a population of women at elevated risk, the National Cancer Institute sponsored a workshop on July 7 and 8, 1998, to develop information to assist in counseling and in weighing the risks and benefits of tamoxifen, Our study was undertaken to develop tools to identify women for whom the benefits outweigh the risks, Methods: Information was reviewed on the incidence of invasive breast cancer and of in situ lesions, as well as on several other health outcomes, in the absence of tamoxifen treatment. Data on the effects of tamoxifen on these outcomes were also reviewed, and methods were developed to compare the risks and benefits of tamoxifen, Results: The risks and benefits of tamoxifen depend on age and race, as well as on a woman's specific risk factors for breast cancer, In particular, the absolute risks from tamoxifen of endometrial cancer, stroke, pulmonary embolism, and deep vein thrombosis increase with age, and these absolute risks differ between white and black women, as does the protective effect of tamoxifen on fractures. Tables and aids are developed to describe the risks and benefits of tamoxifen and to identify classes of women for whom the benefits outweigh the risks. Conclusions: Tamoxifen is most beneficial for younger women with an elevated risk of breast cancer. The quantitative analyses presented can assist health care providers and women in weighing the risks and benefits of tamoxifen for reducing breast cancer risk.