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Cited by 26BRCA gene mutations in cancerCancer Risks and FactorsMultiple and Secondary Primary Cancers

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Tamoxifen and the risk of breast cancer in women with a BRCA1 or BRCA2 mutation

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Kotsopoulos, Joanne, Gronwald, Jacek, Huzarski, Tomasz, Aeilts, Amber, Randall Armel, Susan, Karlan, Beth, Singer, Christian F., Eisen, Andrea, Tung, Nadine, Olopade, Olufunmilayo, Bordeleau, Louise, Eng, Charis, Foulkes, William D., Neuhausen, Susan L., Cullinane, Carey A., Pal, Tuya, Fruscio, Robert, Lubinski, Jan, Metcalfe, Kelly, Sun, Ping, Narod, Steven A., and the Hereditary Breast Cancer Clinical Study Group, Wiesner, Georgia, Poll, Aletta, Kim, Raymond, McCuaig, Jeanna, Zakalik, Dana, Couch, Fergus, Steele, Linda, Saal, Howard, Lemire, Edmond, Serfas, Kim, Sweet, Kevin, Panchal, Seema, Elser, Christine, Reilly, Robert E, Blum, Joanne L, Cybulski, Cezary, Rayson, Daniel, Ramón, Teresa y Cajal, Dungan, Jeffrey, Zovato, Stefania, Rastelli, Antonella, Moller, Pal, Cohen, Stephanie·2023·Breast Cancer Research and Treatment
DOI 10.1007/s10549-023-06991-3
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Abstract

Purpose Chemoprevention with a selective estrogen receptor modulator (tamoxifen or raloxifene) is a non-surgical option offered to high-risk women to reduce the risk of breast cancer. The evidence for tamoxifen benefit is based on trials conducted among predominantly postmenopausal women from the general population and on studies of contralateral breast cancer in women with a pathogenic variant (mutation hereafter) in BRCA1 or BRCA2. Tamoxifen has not been assessed as a primary prevention agent in women with an inherited BRCA mutation. Methods We conducted a prospective analysis of tamoxifen chemoprevention and the risk of breast cancer in women with a BRCA1 or BRCA2 mutation. Data on tamoxifen (and raloxifene) use was collected by questionnaire and updated biennially. Information on incident cancers was collected by self-report and was confirmed by medical record review. In a matched analysis, we estimated the hazard ratio (HR) and 95% confidence intervals (CI) for developing a first primary breast cancer associated with tamoxifen or raloxifene use, using Cox proportional hazards analysis. Results There were 4578 unaffected women in the cohort, of whom 137 reported tamoxifen use (3%), 83 reported raloxifene use (2%) and 12 used both drugs (0.3%). Women who used tamoxifen or raloxifene were matched 1:3 with women who used neither drug on year of birth, country of residence, year of study entry and gene (BRCA1 or BRCA2). We generated 202 matched pairs. After a mean follow-up o…

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  • In a prospective study of 4,578 unaffected women with BRCA1 or BRCA2 variants, after mean follow-up of 6.8 years, breast cancer was diagnosed among 10.9% (22) of tamoxifen/raloxifene users and 14.3% (71) of non-users (HR 0.64; 95% CI 0.40-1.03; P = 0.07).

    “After a mean follow-up of 6.8 years, breast cancer was diagnosed among 22 (10.9%) tamoxifen/raloxifene users and 71 (14.3%) among non-users (HR: 0.64; 95% CI: 0.40 - 1.03; P = 0.07) [6].”

    From Screening, Risk Reduction Strategies, and Clinical Management of Unaffected Carriers of BRCA1 or BRCA2 Pathogenic Variants (2026) · cites this paper as [6]

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Authors
Kotsopoulos, J., Gronwald, J., Huzarski, T., Aeilts, A., Randall Armel, S., Karlan, B., Singer, C. F., Eisen, A., Tung, N., Olopade, O., Bordeleau, L., Eng, C., Foulkes, W. D., Neuhausen, S. L., Cullinane, C. A., Pal, T., Fruscio, R., Lubinski, J., Metcalfe, K., Sun, P., Narod, S. A., and the Hereditary Breast Cancer Clinical Study Group, Wiesner, G., Poll, A., Kim, R., McCuaig, J., Zakalik, D., Couch, F., Steele, L., Saal, H., Lemire, E., Serfas, K., Sweet, K., Panchal, S., Elser, C., Reilly, R. E., Blum, J. L., Cybulski, C., Rayson, D., Ramón, T. Y. C., Dungan, J., Zovato, S., Rastelli, A., Moller, P., & Cohen, S.
Affiliations
  • University of Toronto (CA)
  • International Hereditary Cancer Center (PL)
  • The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
  • University of California, Los Angeles (US)
  • Comprehensive Cancer Center Vienna (AT)
  • Sunnybrook Health Science Centre (CA)
  • Beth Israel Deaconess Medical Center (US)
  • University of Chicago (US)
  • Juravinski Cancer Centre (CA)
  • Cleveland Clinic (US)
  • McGill University (CA)
  • City Of Hope National Medical Center (US)
  • MemorialCare Long Beach Medical Center (US)
  • Vanderbilt-Ingram Cancer Center (US)
  • University of Milano-Bicocca (IT)
  • Women's College Hospital (CA)
Corresponding author
Narod, Steven A.
ORCID
Venue
Breast Cancer Research and Treatment
Publisher
Springer Science and Business Media LLC
Published
2023-07-11
Volume
201
Issue
2
Pages
257-264
ISSN
  • 0167-6806 (ISSN-L)
  • 1573-7217
DOI
10.1007/s10549-023-06991-3
OpenAlex
W4383873232
Cited by
26
References
0
Citations by year
2026: 7 · 2025: 8 · 2024: 6 · 2023: 4
FWCI
4.15
Type
journal article
Language
en
Open access
Licence
Locations
  • Breast Cancer Research and Treatment (publishedVersion)
  • PubMed (publishedVersion)
  • BOA (University of Milano-Bicocca) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
Funders
  • Canadian Institutes of Health Research (FDN 154275)
  • Canadian Cancer Society (703058)
  • Peter Gilgan Foundation
  • Canada Research Chairs
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
  • Health Sciences › Medicine › Epidemiology › Multiple and Secondary Primary Cancers
Keywords
tamoxifen, raloxifene, breast cancer chemoprevention, BRCA1 mutation, BRCA2 mutation, selective estrogen receptor modulators, high-risk women
MeSH terms
Breast Neoplasms, Female, Humans, Mutation, Risk Factors, Tamoxifen, BRCA1 Protein, Genes, BRCA1, Raloxifene Hydrochloride, BRCA2 Protein

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