Tamoxifen saves lives and costs

Research has shown that tamoxifen (Nolvadex) can protect against breast cancer but can have side effects including hot flashes, weight gain, abnormal menstrual periods and nausea.


To investigate those women who can most benefit from tamoxifen as a cancer preventive drug, US researchers analysed 4 randomised, placebo-controlled trials and assessed the effects that tamoxifen would have on breast cancer risk 10 years after the treatment.


Investigators used a mathematical model and found that in post-menopausal women under 55 who have an increased risk of developing breast cancer, the benefits of using tamoxifen to prevent cancer are sufficiently outweigh its side effects, it also saves costs.


Source: Cost-effectiveness of chemoprevention of breast cancer using tamoxifen in a postmenopausal US population. Cancer, 2011; published online 14 March 2011

Calcium and vitamin D do not prevent breast cancer

Previous studies have reported vitamin D supplements may reduce breast cancer risk but a new study, published online in the Journal of the National Cancer Institute, found that calcium and vitamin-D supplements do not reduce breast cancer incidence in postmenopausal women.

More than 36,000 postmenopaused women were randomly assigned to take 1000 mg of calcium plus 400 IU of vitamin D daily or placebo. Researchers found that the incidence of breast cancer was similar in the supplement ( 528) and placebo ( 546) groups. The authors concluded that " the main findings do not support a causal realtionship between calcium and vitamin D supplement use and reduced breast cancer incidence".

In an accompanying editorial "Breast Cancer Prevention Using Calcium and Vitamin D: A Bright Future?" ( free f/t), the authors say that the study results may have been affected by multiple "important confounders" and that vitamin D and calcium may still have a "bright future" in breast cancer prevention and further studies will be needed.

Source: "Calcium Plus Vitamin D Supplementation and the Risk of Breast Cancer" Journal of the National Cancer Institute. Advance Access published online on November 11, 2008 JNCI, doi:10.1093/jnci/djn360

HRT pills double risk of blood clots

Researchers in France and Glasgow carried out a systematic review and meta-analysis on some studies looking at the risk of venous thromboembolism in women taking hormone replacement therapy HRT) - the BBC reported.


They concluded that "current use of oral oestrogen increases the risk of venous thromboembolism by twofold to threefold" and they said that HRT patch may be safer but further research is needed.


The critics say this new study provides valuable evidence about the size of the risks and gives some idea of the difference between patches and pills, but women should not assume that it is unsafe to take HRT pills or patches are safe.


Source: "Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis" BMJ, published 20 May 2008. Ahead of print ( f/t via Athens)

Calcium supplements may increase heart attack risk

The Telegraph reported researchers in New Zealand found that calcium supplements may increase the risk of heart attack in healthy postmenopausal women.

1,471 postmenopausal women of average age 74 were randomly assigned to receive calcium supplement or placebo, followed for 5 years, researchers found heart attacks were more common in the women taking the calcium supplements. The report was published in the BMJ Online, the authors said the results are not conclusive but suggest that high calcium intakes might have an adverse effect on vascular health. Some experts in the field found the conclusion surprising and urged patients not to stop taking the supplements.

Source: "Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial." BMJ 2008:394405257 published online, 15 January 2008 ( full text via Athens)

HRT risk for older women - WISDOM trial

A new multicentre, randomised, doubled blind placebo controlled trial was carried out in the UK, Australia and New Zealand to assess the risks and benefits of combined HRT vs placebo or oestrogen alone.

The results are consistent with the findings of the WHI ( US) study, researchers concluded that HRT "increases cardiovascular and thromboembolic risk when started many years after the menopause."


The study is published in the early online issue of BMJ, 11 July 2007. "Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women". Read the abstract .

The trial was prematurely closed after the WHI publication of the early results of the danger of HRT on older women. Read more...


See also previous post "Estrogen therapy and healthier arteries"