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| Tamoxifen link to second tumours | Tamoxifen link to second tumours |
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| Tamoxifen is given to most women with breast cancer | |
| Long-term use of a common breast cancer drug may increase the risk of developing a deadly second tumour, a study suggests. | |
| Tamoxifen, given to thousands of British women, prevents tumours being fuelled by the sex hormone oestrogen, and stops them returning after surgery. | Tamoxifen, given to thousands of British women, prevents tumours being fuelled by the sex hormone oestrogen, and stops them returning after surgery. |
| But a US study links use of the drug to a four-fold raised risk of developing a more aggressive, difficult-to-treat tumour, not dependent on oestrogen. | But a US study links use of the drug to a four-fold raised risk of developing a more aggressive, difficult-to-treat tumour, not dependent on oestrogen. |
| However, women are strongly advised not to stop taking tamoxifen. | However, women are strongly advised not to stop taking tamoxifen. |
| Women should be reassured that the benefits of taking hormone-blocking drugs, such as tamoxifen, after their first diagnosis of breast cancer far outweigh any potential risks Dr Alison RossCancer Research UK | Women should be reassured that the benefits of taking hormone-blocking drugs, such as tamoxifen, after their first diagnosis of breast cancer far outweigh any potential risks Dr Alison RossCancer Research UK |
| Experts stress any risks of taking the drug are far outweighed by the benefits. | Experts stress any risks of taking the drug are far outweighed by the benefits. |
| They said the odds of developing a second, non-hormone sensitive tumour remained very low. | They said the odds of developing a second, non-hormone sensitive tumour remained very low. |
| Each year around 45,500 women in the UK are diagnosed with breast cancer and 12,000 die from the disease. | Each year around 45,500 women in the UK are diagnosed with breast cancer and 12,000 die from the disease. |
| Around two thirds of breast cancers are sensitive to the hormone oestrogen. | Around two thirds of breast cancers are sensitive to the hormone oestrogen. |
| Tamoxifen become the "gold standard" treatment for these hormone-sensitive tumours, although in recent years newer drugs have started to be preferred. | Tamoxifen become the "gold standard" treatment for these hormone-sensitive tumours, although in recent years newer drugs have started to be preferred. |
| The latest study, by the Fred Hutchinson Cancer Research Center in Seattle, looked at long-term use of the drug among more than 1,000 women. | The latest study, by the Fred Hutchinson Cancer Research Center in Seattle, looked at long-term use of the drug among more than 1,000 women. |
| The researchers, writing in the journal Cancer Research, found that tamoxifen reduced the chances of oestrogen-positive breast cancer returning by 60%. | The researchers, writing in the journal Cancer Research, found that tamoxifen reduced the chances of oestrogen-positive breast cancer returning by 60%. |
| But they also found that five or more years of treatment was associated with a 440% increase in the chance of an aggressive, non-hormone sensitive tumour appearing in the opposite breast. | But they also found that five or more years of treatment was associated with a 440% increase in the chance of an aggressive, non-hormone sensitive tumour appearing in the opposite breast. |
| These tumours can be particularly difficult to treat. | These tumours can be particularly difficult to treat. |
| Many women in the UK cease tamoxifen treatment after five years to avoid side effects, but several thousand woman have been on the drug for a longer time. | Many women in the UK cease tamoxifen treatment after five years to avoid side effects, but several thousand woman have been on the drug for a longer time. |
| Risks and benefits | Risks and benefits |
| Lead researcher Dr Christopher Li said: "It is clear that oestrogen-blocking drugs like tamoxifen have important clinical benefits and have led to major improvements in breast cancer survival rates. | Lead researcher Dr Christopher Li said: "It is clear that oestrogen-blocking drugs like tamoxifen have important clinical benefits and have led to major improvements in breast cancer survival rates. |
| "However, these therapies have risks, and an increased risk of ER negative (oestrogen receptor negative) second cancer may be one of them. | "However, these therapies have risks, and an increased risk of ER negative (oestrogen receptor negative) second cancer may be one of them. |
| "Still, the benefits of this therapy are well established and doctors should continue to recommend hormonal therapy for breast cancer patients who can benefit from it." | "Still, the benefits of this therapy are well established and doctors should continue to recommend hormonal therapy for breast cancer patients who can benefit from it." |
| Professor Jack Cuzick, head of Cancer Research UK's Centre for Epidemiology, Mathematics and Statistics at Queen Mary, University of London, stressed that tamoxifen had a proven track record. | Professor Jack Cuzick, head of Cancer Research UK's Centre for Epidemiology, Mathematics and Statistics at Queen Mary, University of London, stressed that tamoxifen had a proven track record. |
| He said: "There is overwhelming evidence that tamoxifen, and newer more effective hormone blocking treatments, prevent far more recurrences, new breast cancers and cancer-related deaths than they might stimulate." | He said: "There is overwhelming evidence that tamoxifen, and newer more effective hormone blocking treatments, prevent far more recurrences, new breast cancers and cancer-related deaths than they might stimulate." |
| Professor Cuzick said some of the non-hormone sensitive tumours recorded in the study may have started out as hormone-sensitive, but had been kept at bay by tamoxifen treatment. | Professor Cuzick said some of the non-hormone sensitive tumours recorded in the study may have started out as hormone-sensitive, but had been kept at bay by tamoxifen treatment. |
| Dr Alison Ross, senior science information officer at Cancer Research UK, said: "Women should be reassured that, based on extensive scientific evidence, the benefits of taking hormone-blocking drugs, such as tamoxifen, after their first diagnosis of breast cancer far outweigh any potential risks. | Dr Alison Ross, senior science information officer at Cancer Research UK, said: "Women should be reassured that, based on extensive scientific evidence, the benefits of taking hormone-blocking drugs, such as tamoxifen, after their first diagnosis of breast cancer far outweigh any potential risks. |
| "More research will be needed to confirm the possible link between its long-term use and the relatively rare occurrence of an aggressive form of the disease in the other breast." | "More research will be needed to confirm the possible link between its long-term use and the relatively rare occurrence of an aggressive form of the disease in the other breast." |