Many women at high risk for breast cancer are foregoing tamoxifen, the first FDA-approved drug for prevention of breast cancer, due to concerns about side effects, increased risk of other cancers, and lack of information, a new study by researchers in Boston shows. The study will be published December 14 in the Journal of Clinical Oncology.
"While the availability of tamoxifen is a significant advance in breast cancer prevention, it also presents a complicated decision for women at high risk for the disease," said Sharon Bober, PhD, Clinical Instructor in the Department of Psychiatry at Harvard Medical School, Staff Psychologist at the Beth Israel Deaconess Medical Center and Dana-Farber Cancer Institute, and lead author of the study. "Our study underscores the need to address psychological factors that may influence decision-making, in order to help women feel confident and satisfied with their treatment choice."
Tamoxifen has been shown to reduce risk of invasive and non-invasive breast cancer by almost 50 percent. However, tamoxifen also increases the risk of endometrial cancer, blood clots, cataracts, and more severe menopausal symptoms, such as hot flashes and night sweats.
Researchers also assessed how participants felt about their decision, finding that anxiety and psychological distress influenced whether or not they were satisfied with their decision. Women who cited fewer sources of information were more likely to feel dissatisfied with their decision. Although decision satisfaction did not vary between women who chose or declined treatment, those who experienced heightened anxiety about cancer or about treatment side effects were less likely to feel satisfied with their decision.
Researchers noted that previous studies suggest that dissatisfaction with their decision may lead some women to prematurely discontinue treatment, and underscored the need to help women make informed decisions.
"This study highlights the complexity of making important medical decisions, and underscores the need for improved patient-physician communication to help patients weigh the risks and benefits of therapy," Dr. Bober added. "Women are willing to grapple with difficult decisions in order to reduce their risk of breast cancer. But for many women, the benefits of the best available preventive medication are not sufficient."
Danielle Potuto | EurekAlert!
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