Dear OncoLink "Ask The Experts,"
Given the risk of endometrial cancer with tamoxifen use, is the drug contraindicated for women who have previously had endometrial cancer, but now face breast cancer? I was treated with TAH/BSO for stage IB endometrial cancer 7 months ago, and now face the decision of tamoxifen for a new breast cancer diagnosis.
Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:
Although tamoxifen increases the risk of endometrial cancer, it is reasonable to use it in a woman who has had an early stage endometrial cancer with a very low risk of recurrence after treatment. There is no good evidence that estrogen replacement therapy after treatment for low-risk endometrial cancer increases the risk of recurrence, and so it is unlikely that tamoxifen, which can act as a weak estrogen, would have an effect.