Tamoxifen treatment and its outcome in breast cancer patients at a hospital-based cancer registry in Kerala
Keywords:Breast cancer, Tamoxifen, Hospital based cancer registry, Kerala
Background: Endocrine therapy for breast cancer is directed at reducing oestrogen synthesis or alternatively blocking oestrogen receptors (ER) in tumour-sensitive tumors. Despite side effects, the use of systemic adjuvant therapy after local management of breast cancer substantially improves survival and reduces the risk of relapse. The study objective was to assess the recurrence of breast cancer and the complications seen in breast cancer patients on tamoxifen therapy at a hospital-based cancer registry, Thrissur, Kerala.
Methods: After obtaining institutional ethical clearance, included 75 patients of histologically diagnosed breast carcinoma currently on tamoxifen, diagnosed in the year of 2016. Data was obtained from the patient files and by personal intimation.
Results: Of the 75 patients on tamoxifen, four (5.33%) patients had history of recurrence. 22.6% of patients on tamoxifen were noted to have increased endometrial thickness. Other side effects noted were weight gain, TIA, bone pain and vaginal discharge.
Conclusions: It was found that the recurrence rate at three years for the study population was 5.33%. More studies from developing countries, with larger sample size and clinical trials will give us more accurate information regarding the efficacy of the drug.
Harrison TR, Fauci A, Kasper D, Hauser SL, Jameson JL, Localzo J. In: Harrison’s Principle of Internal Medicine. 18th Edition. United States: McGraw Hill Education; 2012;754.
McGuire WL, Carbone PP, Sears ME, Escher GC. In “Estrogen Receptors in Human Breast Cancer” (W. L. McGuire, P. P. Carbone and E. P. Vollner, eds). Raven Press, New York. 1975;1-7
McGuire WL, Zava DT, Horwitz KB, Chamness GC. Steroid Receptors in breast tumours-current status. Curr. Topics Exp Endocr. 1977;3:93-129.
William L, McGuire. Breast Cancer 1- Advances in Research and Treatment-Current approaches to therapy. United States: Springer. 2014;228.
Knight WA, Livingston RB, Gregory BJ, McGuire WL. Estrogen receptor as an independent prognostic factor for early recurrence in breast cancer. Cancer res. 1977;36:4602-9.
Maynard PV, Blamey RW, Elston CW, Haybrittle JL, Griffiths K. Estrogen receptor assay in primary breast cancer and early recurrence of the disease. Cancer res. 1978:38:4292-5.
Sriram Bhat M. In: SRB’s Manual of Surgery. 5th Edition. India: Jaypee Brothers Medical Publishers Ltd; 2019;550.
Harris JR, Lippman ME, Marrow M, Hellman S. Diseases of the Breast. 1st Edition. Philadelphia: Lippincott-Raven. Ann Surg. 2001;233(4):594.
Early Breast Cancer Trialist’s Collaborative Group. Systemic treatment of early breast cancer by hormonal, cytotoxic or immune therapy. Lancet. 1993;339(1):71.
Fisher B, Costantino J, Redmond C, Poisson R, Bowman D, Couture J et al. A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have oestrogen receptor positive tumours. N Engl J Med. 1989;320(8):479.
Powles TJ, Ashley S, Tidy A, Smith IE, Dowsett M. Twenty-Year Follow-up of the Royal Marsden Randomized, Double-Blinded Tamoxifen Breast Cancer Prevention Trial. J National Cancer Institute. 2007;99(4):283-90.
Fristch M, Jordan VC. Long term tamoxifen therapy for treatment of breast cancer. Cancer Control. 1994;1(4)356-66.
Ashraf M, Biswas J, Majumdar S, Nayak S, Alam N, Mukherjee K et al. Tamoxifen Use in Indian Women - Adverse Effects Revisited. Asian Pacific journal of cancer prevention: Asian Pac J Cancer Prev. 2009;10:609-1.
Matthew P, Goetz C, Erlichman C, Loprinzi L. Pharmocology of endocrine manipulation. In ‘Cancer Principles and Practice of Oncology. 8th ed.2008;1:557-8.
Hoda D, Perez DG, Loprinzi CL. Hot flashes in breast cancer survivors. Breast. 2003;9(5):431-8.
Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS. Spectrum of breast cancer in Asian women. World J Surg. 2007;31:1031-40.