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William J. Gradishar

to the group of patients who had not been exposed to adjuvant tamoxifen. Dr. Gradishar questioned whether this outcome was clinically relevant. He stated that even though the SWOG trial may support administering combination therapy in first

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Robert Swarm, Amy Pickar Abernethy, Doralina L. Anghelescu, Costantino Benedetti, Craig D. Blinderman, Barry Boston, Charles Cleeland, Nessa Coyle, Oscar A. deLeon-Casasola, June G. Eilers, Betty Ferrell, Nora A. Janjan, Sloan Beth Karver, Michael H. Levy, Maureen Lynch, Natalie Moryl, Barbara A. Murphy, Suzanne A. Nesbit, Linda Oakes, Eugenie A. Obbens, Judith A. Paice, Michael W. Rabow, Karen L. Syrjala, Susan Urba, and Sharon M. Weinstein

hepatic enzyme, CYP2D6. 29 , 30 Because data suggest that CYP2D6-inhibiting antidepressants increase risk of recurrence in patients with breast cancer treated with tamoxifen 31 , 32 (see Additional Therapies, page 1082), it is reasonable to assume that

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predictor of breast cancer outcomes; however, several emerging biomarkers, such as the CYP 2D6 genotype to determine tamoxifen (Soltamox, AstraZeneca Pharmaceuticals, LP) efficacy, are also being researched extensively. “The efficacy of tamoxifen therapy

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Jagar Jasem, Christine M. Fisher, Arya Amini, Elena Shagisultanova, Rachel Rabinovitch, Virginia F. Borges, Anthony Elias, and Peter Kabos

studies was based on the SWOG-8814 randomized clinical trial, the results of which were published in 2009 and showed that adjuvant treatment including both chemotherapy and tamoxifen yielded a longer survival benefit over tamoxifen alone in hormone

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Allan Lipton, Robert Uzzo, Robert J. Amato, Georgiana K. Ellis, Behrooz Hakimian, G. David Roodman, and Matthew R. Smith

Mouridsen H Gershanovich M Sun Y . Superior efficacy of letrozole versus tamoxifen as first-line therapy for postmenopausal women with advanced breast cancer: results of a phase III study of the International Letrozole Breast Cancer Group . J Clin Oncol

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Kenneth Offit

advised. An example of a guideline based on risk threshold can be drawn from the Tamoxifen prevention trial that used a 1.67% 5-year risk of developing breast cancer for a 60-year-old woman enrolled in the trial. 6 Population-based mammogram screening

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Crystal S. Denlinger, Tara Sanft, K. Scott Baker, Shrujal Baxi, Gregory Broderick, Wendy Demark-Wahnefried, Debra L. Friedman, Mindy Goldman, Melissa Hudson, Nazanin Khakpour, Allison King, Divya Koura, Elizabeth Kvale, Robin M. Lally, Terry S. Langbaum, Michelle Melisko, Jose G. Montoya, Kathi Mooney, Javid J. Moslehi, Tracey O'Connor, Linda Overholser, Electra D. Paskett, Jeffrey Peppercorn, M. Alma Rodriguez, Kathryn J. Ruddy, Paula Silverman, Sophia Smith, Karen L. Syrjala, Amye Tevaarwerk, Susan G. Urba, Mark T. Wakabayashi, Phyllis Zee, Deborah A. Freedman-Cass, and Nicole R. McMillian

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Survivorship define menopause as no menses for 1 year in the absence of prior chemotherapy or tamoxifen use, or no menses after surgical removal of all ovarian tissue. Healthy women

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Rodger J. Winn

.nccn.org . 16 Chlebowski RT Col N Winer EP . American Society of Clinical Oncology Technology Assessment of pharmacologic interventions for breast cancer risk reduction including tamoxifen, raloxifene, and aromatase inhibition . J Clin Oncol 2002 ; 20

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Stefanie S. Jeffrey, Per Eystein Lønning, and Bruce E. Hillner

; 44 : 671 – 675 . 53 Group EBCTC . Polychemotherapy for early breast cancer: an overview of the randomised trials . Lancet 1998 ; 352 : 930 – 942 . 54 Group EBCTC . Tamoxifen for early breast cancer: An overview of the

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Kaylene Ready and Banu Arun

; chemoprevention in the form of tamoxifen, which may reduce breast cancer risk by up to 50% 4 , 5 ; prophylactic mastectomy, which reduces breast cancer risk by 90% to 95% 5 – 7 ; and prophylactic oophorectomy, which reduces breast cancer risk by 55% to 70% if