| Breast Cancer, the
Disease |
 |
 |
16% of the death cases from cancer in Egypt
are due to breast cancer. |
|
Cancer Breast is estrogen depedent. |
|
Evidence of association between changes
in oestrogen receptors concentrations and
rsik factors in breast cancer. |
|
Anti-estrogen therapy is very
essential with most chemotheraputic agents
and after mastectomy as an adjuvant therapy.
|
|
 |
| Tamofen
for the Treatment of Breast Cancer |
the
most widely used Anti-Estrogen for the treatment
of breast cancer. |
| |
The
1st Line Treatment in breast cancer |
|
|
 |
|
| Composition: |
|
| Each scored tablet contains Tamoxifen
citrate equivalent to 10 mg Tamoxifen. |
|
|
| Indications: |
|
|
Adjuvant therapy in early post surgical
breast cancer. |
|
Adjuvant treatment in advanced breast cancer,
contrlateral breast cancer, and distant metastasis. |
|
Tamoxifen is indicated to reduce the risk
of developing breast cancer in women who have
been determined to be at high risk of developing
breast cancer.
N.B. A woman is concidered to be at high risk
when she is at least 35 years old and has
5-year predicated risk of developing breast
cancer greater than or equal to 1.67% ased
on Gail Model Risk Assesment Tool. |
|
|
|
| Dosage: |
|
|
Treatment of breast cancer |
| |
20 - 40 mg daily. (Doses more than 20
mg /day is given in two divided doses).
The reduction in recurrence and mortality
was greater in those studies that used tamoxifen
for 5 years than in those that used it for
a shorter period. |
|
2. Reduction in breast
cancer incidence in high-risk women (prophylaxis) |
| |
20 mg daily for 5 years. |
|
|
|
| Side
Effects : |
|
One should differentiate between
long term course related side effects as in the
prevention or treatment of cancer breast; and
short term course related side effects, such as
during the treatment of female infertility or
other gynaecological conditions. In short course
indications, in general adverse reactions are
extremely rare, they are less likely to occur
and are much less severe than other anti-estrogens.
During the prophylaxis or treatment of cancer
patients who are under long courses of tamoxifen,
adverse reactions are usually mild, dose related
and rarely require discontinuation of therapy.
In Females:
|
Most frequent: Hot flushes; mild
gastrointestinal intolerance. |
|
Less frequent: Vaginal discharge;
menstrual irregularities; skin rash; vaginal
bleeding; these are usually not sever to require
dose reduction or discontinuation. |
|
Infrequent: Hypercalcemia; edema;
pruritus vulvae; depression; dizziness; headache;
retinopathy; thrombocytopenia; leukopenia.
|
|
|
|
| Contra-Indications: |
|
| Pregnancy - Hypersensitivity to tamoxifen |
|
|
| Precautions: |
|
| Tamoxifen should be prescribed with
caution for women who have not reached menopause
or who have not had menopause artificially induced.
For sexually active women of child-bearing potential,
initiate tamoxifen therapy during menstruation.
In women with menstrual irregularity, a negative
B-HCG immediately prior to initiation of therapy
is sufficient. |
|
|
| How
Supplied: |
|
| Boxes of 30 scored tablets. |
|
|
| References: |
|
| 1. |
J- Clin – oncol. 1993
March. |
| 2. |
Dtsch – Med – Wochenschr. 1992
Dec. |
| 3. |
Monogr – Natl – Cancer –
Inst. 1992. |
|
|
|
