Dr. Graff on Tamoxifen De-Escalation in Breast Cancer

Stephanie L. Graff, MD, director of the Breast Program at the Sarah Cannon Cancer Institute of HCA Midwest Health, and associate director of the Breast Cancer Research Program at Sarah Cannon Research Institute, discusses the use of tamoxifen in the treatment of patients with breast cancer.

At the 2018 San Antonio Breast Cancer Symposium, data were presented on the use of tamoxifen in women with ductal carcinoma in situ (DCIS) or higher-risk, precancerous lesions—such as lobular carcinoma in situ or atypical ductal hyperplasia, explains Graff. For the trial, investigators compared the benefit of 5 mg of tamoxifen versus no therapy in a preventive setting. Although the standard dose of tamoxifen is 20 mg, it has been associated with several severe adverse events, such as thromboembolic disease and uterine carcinoma, she notes.

Data showed that the 5 mg dose was beneficial to patients compared with no therapy, which suggests that de-escalation is possible in patients with stage 0 DCIS who may be concerned about adverse events or have poor tolerance, concludes Graff.