Evidence mapPaperPMID 35378642Full record

ArticleBreast cancer research and treatment2022

Initiation and tolerance of chemoprevention among women with high-risk breast lesions: the potential of low-dose tamoxifen.

Brittany Bychkovsky, Alison Laws, Fisher Katlin, Marybeth Hans, Mary Knust Graichen, Lydia E Pace, Rochelle Scheib, Judy E Garber, Tari A King

Open access · bronzeAbstract read
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Article in Breast cancer research and treatment, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
2.5field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 27 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Brittany BychkovskyHarvard Medical School, Boston, MA, USA.
Alison LawsHarvard Medical School, Boston, MA, USA.
Fisher KatlinDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Marybeth HansDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Mary Knust GraichenDivision of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Lydia E PaceHarvard Medical School, Boston, MA, USA.
Rochelle ScheibHarvard Medical School, Boston, MA, USA.
Judy E GarberHarvard Medical School, Boston, MA, USA.
Tari A KingHarvard Medical School, Boston, MA, USA. Tking7@bwh.harvard.edu.ORCID http://orcid.org/0000-0003-3602-2351
Brigham and Women's Hospital · USHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHigh-risk lesions (HRLs) of the breast are an indication for chemoprevention, yet uptake is low, largely due to concerns about side effects. In 2019, low-dose (5 mg) tamoxifen was demonstrated to reduce breast cancer risk with improved tolerance. We describe chemoprevention uptake in an academic clinic before and after the introduction of low-dose tamoxifen.

methodsFemales age ≥ 35 with HRLs who established care from April 2017 through January 2020 and eligible for chemoprevention were included. Rates of chemoprevention initiation before and after the introduction of low-dose tamoxifen (pre-2019 vs. post-2019) were compared with chi-squared tests. Logistic regression identified demographic and clinical factors associated with chemoprevention initiation. Kaplan-Meier methods determined the rates of discontinuation.

resultsAmong 660 eligible females with HRLs, 22.7% initiated chemoprevention. Median time from first visit to chemoprevention initiation was 54 days (interquartile range (IQR): 0-209); 31.0% (46/150) started chemoprevention > 6 months after their initial visit. Chemoprevention uptake was not significantly different pre-2019 vs. post-2019 (21.2% vs. 26.3%, p = 0.16); however, post-2019, low-dose tamoxifen became the most popular option (41.5%, 34/82). On multivariable analyses, age and breast cancer family history were significantly associated with chemoprevention initiation. Discontinuation rates at 1 year were lowest for low-dose tamoxifen (6.7%) vs. tamoxifen 20 mg (15.0%), raloxifene (20.4%), or an aromatase inhibitor (20.0%).

conclusionIn this modern cohort, 22.7% of females with HRLs initiated chemoprevention with 31.0% initiating chemoprevention > 6 months after their first visit. Low-dose tamoxifen is now the most popular choice for chemoprevention, with low discontinuation rates at 1 year.

Indexed as

Breast NeoplasmsTamoxifenAromatase InhibitorsChemopreventionFemaleHumansRaloxifene HydrochlorideAromatase InhibitorsRaloxifene HydrochlorideTamoxifenAtypical ductal hyperplasia (ADH)Atypical lobular hyperplasia (ALH)ChemopreventionHigh-risk lesionsLobular carcinoma in situ (LCIS)Low-dose tamoxifen

Identifiers

PMID35378642
PMCPMC8978759
OpenAlexW4226097827

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.