Uptake of tamoxifen in consecutive premenopausal women under surveillance in a high-risk breast cancer clinic.
Donnelly, L Evans, D Wiseman, J Fox, J Greenhalgh, R Affen, J Juraskova, I Stavrinos, P Dawe, S Cuzick, J
Donnelly, L
Evans, D
Wiseman, J
Fox, J
Greenhalgh, R
Affen, J
Juraskova, I
Stavrinos, P
Dawe, S
Cuzick, J
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Abstract
Background:Randomised trials of tamoxifen versus placebo indicate that tamoxifen reduces breast cancer risk by approximately 33%, yet uptake is low. Approximately 10% of women in our clinic entered the IBIS-I prevention trial. We assess the uptake of tamoxifen in a consecutive series of premenopausal women not in a trial and explore the reasons for uptake through interviews.Methods:All eligible women between 33 and 46 years at 17% lifetime risk of breast cancer and undergoing annual mammography in our service were invited to take a 5-year course of tamoxifen. Reasons for accepting (n=15) or declining (n=15) were explored using semi-structured interviews.Results:Of 1279 eligible women, 136 (10.6%) decided to take tamoxifen. Women >40 years (74 out of 553 (13.4%)) and those at higher non-BRCA-associated risk were more likely to accept tamoxifen (129 out of 1109 (11.6%)). Interviews highlighted four themes surrounding decision making: perceived impact of side effects, the impact of others' experience on beliefs about tamoxifen, tamoxifen as a 'cancer drug', and daily reminder of cancer risk.Conclusions:Tamoxifen uptake was similar to previously ascertained uptake in a randomised controlled trial (IBIS-I). Concerns were similar in women who did or did not accept tamoxifen. Decision making appeared to be embedded in the experience of significant others.British Journal of Cancer advance online publication, 4 March 2014; doi:10.1038/bjc.2014.109 www.bjcancer.com.
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2014-03-04
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Uptake of tamoxifen in consecutive premenopausal women under surveillance in a high-risk breast cancer clinic. 2014: Br J Cancer