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Amy Cyr

-negative and node-positive postmenopausal patients with breast cancer treated with anastrozole or tamoxifen: a TransATAC study . J Clin Oncol 2010 ; 28 : 1829 – 1834 . 5. Grotenhuis BA Vrijland WW Klem TM . Radiofrequency ablation for early

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Hiram S. Cody III and Kimberly J. Van Zee

: Findings from the National Surgical Adjuvant Breast and Bowel Project B-17 . J Clin Oncol 1998 ; 16 : 441 – 452 . 19 Fisher B Dignam J Wolmark N . Tamoxifen in the treatment of intraductal breast cancer: National Surgical Adjuvant Breast and

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Michael B. Streiff

drug therapy in women with stage II breast cancer . N Engl J Med 1988 ; 318 : 404 – 407 . 12. Pritchard KI Paterson AH Paul NA . Increased thromboembolic complications with concurrent tamoxifen and chemotherapy in a randomized trial of

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Sushmita Gordhandas, William A. Zammarrelli III, Eric V. Rios-Doria, Angela K. Green, and Vicky Makker

tamoxifen exposure also increase EC risk. Individuals with Lynch syndrome and Cowden syndrome have genetic increased risk of EC, and emerging data indicate a potential role for BRCA1/2 germline pathogenic variants in the development of high-grade EC. 8 , 9

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Mary B. Daly, Tuya Pal, Michael P. Berry, Saundra S. Buys, Patricia Dickson, Susan M. Domchek, Ahmed Elkhanany, Susan Friedman, Michael Goggins, Mollie L. Hutton, CGC, Beth Y. Karlan, Seema Khan, Catherine Klein, Wendy Kohlmann, CGC, Allison W. Kurian, Christine Laronga, Jennifer K. Litton, Julie S. Mak, LCGC, Carolyn S. Menendez, Sofia D. Merajver, Barbara S. Norquist, Kenneth Offit, Holly J. Pederson, Gwen Reiser, CGC, Leigha Senter-Jamieson, CGC, Kristen Mahoney Shannon, Rebecca Shatsky, Kala Visvanathan, Jeffrey N. Weitzel, Myra J. Wick, Kari B. Wisinski, Matthew B. Yurgelun, Susan D. Darlow, and Mary A. Dwyer

has been suggested that the increased risk for endometrial cancer observed in some carriers of BRCA1/2 pathogenic or likely pathogenic variants may be due to the use of tamoxifen therapy by these women rather than the presence of a gene mutation. 118

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Nadeem Abu-Rustum, Catheryn Yashar, Rebecca Arend, Emma Barber, Kristin Bradley, Rebecca Brooks, Susana M. Campos, Junzo Chino, Hye Sook Chon, Christina Chu, Marta Ann Crispens, Shari Damast, Christine M. Fisher, Peter Frederick, David K. Gaffney, Robert Giuntoli II, Ernest Han, Jordan Holmes, Brooke E. Howitt, Jayanthi Lea, Andrea Mariani, David Mutch, Christa Nagel, Larissa Nekhlyudov, Mirna Podoll, Ritu Salani, John Schorge, Jean Siedel, Rachel Sisodia, Pamela Soliman, Stefanie Ueda, Renata Urban, Stephanie L. Wethington, Emily Wyse, Kristine Zanotti, Nicole R. McMillian, and Shaili Aggarwal

supplemental estrogen, and high-fat diet), early age at menarche, nulliparity, late age at menopause, Lynch syndrome, ages between 55 and 64 years, and tamoxifen use. 1 – 6 Data show that almost 67% of patients with adenocarcinoma of the endometrium are

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Nikhil Khandelwal, Ian Duncan, Tamim Ahmed, Elan Rubinstein, and Cheryl Pegus

cohort completed the 5-year course of tamoxifen treatment. A recent survey of managed care organizations showed that approximately 45% of oral chemotherapy is dispensed through retail pharmacy channels, 31% through specialty pharmacies, 16% through mail

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Annika M. Gustafson, Deborah J. Goldfrank, William A. Dunson, Daniel L. Mulkerin, Rebecca L. Caires, and Keith D. Eaton

can result in lowered IQ and fetal malformation, depending on gestational age of the fetus and exposure level. 6 Hormonal treatments such as tamoxifen can result in a high frequency of congenital abnormalities, requiring the use of reliable birth

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Metastatic Breast Cancer, Version 1.2012

Featured Updates to the NCCN Guidelines

Robert W. Carlson, D. Craig Allred, Benjamin O. Anderson, Harold J. Burstein, Stephen B. Edge, William B. Farrar, Andres Forero, Sharon Hermes Giordano, Lori J. Goldstein, William J. Gradishar, Daniel F. Hayes, Clifford A. Hudis, Steven Jay Isakoff, Britt-Marie E. Ljung, David A. Mankoff, P. Kelly Marcom, Ingrid A. Mayer, Beryl McCormick, Lori J. Pierce, Elizabeth C. Reed, Mary Lou Smith, Hatem Soliman, George Somlo, Richard L. Theriault, John H. Ward, Antonio C. Wolff, Richard Zellars, Rashmi Kumar, and Dorothy A. Shead

adjuvant tamoxifen experienced the greatest benefit with the combination endocrine therapy. The reason for the divergent outcomes in the 2 studies is not known. NCCN Guidelines Insights : Metastatic Breast Cancer, Version 1.2012 Version 1

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Laura Spring, Rachel Greenup, Andrzej Niemierko, Lidia Schapira, Stephanie Haddad, Rachel Jimenez, Suzanne Coopey, Alphonse Taghian, Kevin S. Hughes, Steven J. Isakoff, Leif W. Ellisen, Barbara L. Smith, Michelle Specht, Beverly Moy, and Aditya Bardia

population suggesting very young women (age <35 years) are less likely to benefit from adjuvant hormone therapy, perhaps due to de novo tamoxifen resistance, highlighting the need to develop better therapies for this population. 6 Based on the results of the