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(Circulation. 2005;111:539-541.)
© 2005 American Heart Association, Inc.

Editorial

Tamoxifen

Preventing Breast Cancer and Placing the Risk of Deep Vein Thrombosis in Perspective

Samuel Z. Goldhaber, MD

From the Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.

Correspondence to Samuel Z. Goldhaber, MD, Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. E-mail sgoldhaber@partners.org

Key Words: Editorials • thrombosis • pharmacology • risk factors • heparin

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Breast cancer exposes hidden psychological fears and raises fundamental questions about mortality, self-image, and sexuality. It conjures fear of pain, disfigurement, and metastases to bone, liver, and brain. All of us have known young women stricken suddenly with aggressive breast cancer that leads to rapid deterioration, immobility, and death. More common is indolent breast cancer, perhaps controlled, perhaps spreading slowly, for which waiting 10 years or more will eventually help us declare whether an individual patient has achieved a cure.

See p 650

Every year, women at risk are reminded about their susceptibility. They schedule annual mammograms many months in advance. On the day of breast imaging, a curious culture develops in the waiting room. There is a pervasive combination of awkward silence, nervous chatter, and private speculation about the verdict for oneself and for strangers sharing the same experience. The mammogram itself is uncomfortable; it has been likened to lying underneath the garage door while it is closing. After the initial mammogram is obtained, more waiting ensues while the films are evaluated. Callbacks from the waiting room to undergo additional imaging can mean anything from a technical glitch to the first clue that a serious tumor has been detected.

Mammography facilitates early detection but does not prevent breast cancer. To protect against breast cancer, a healthy lifestyle is useful; however, a program of tobacco abstinence, exercise, and maintenance of lean weight with sound nutrition is more effective in reducing rates of myocardial infarction than of breast cancer.

Tamoxifen has . . . [Full Text of this Article]

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Effect of Tamoxifen on Venous Thromboembolic Events in a Breast Cancer Prevention Trial

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Circulation 2005 111: 650-656. [Abstract] [Full Text]