FOLLOW-UP OF WOMEN TREATED WITH TAMOXIFEN

Tamoxifen is a nonsteroidal anti-estrogen frequently used in breast ca ncer therapy, Side effects to tamoxifen are uncommon (2%) but should b e recognized and detected early by careful follow-up, Tamoxifen adjuva nt therapy is absolutely indicated in postmenopausal breast cancer wit h estrogen-receptor - positive nodes, Recently, this indication has be en extended to negative-node postmenopausal breast cancer, Mild acute side effects are the most frequent: hot flushes, menstrual irregularit y, nausea, headache, vertigo, minimal modifications in blood cell coun ts, However, more serious accidents can occur, Increased risk of throm boembolism is linked to a fall in the level of antithrombin III. Ocula r toxicity can occur. If such ocular lesions are diagnosed early enoug h, they can be cured by promptly withdrawing treatment. For patients g iven tamoxifen, there appears to be a small increase in risk of endome trial carcinoma, especially if the daily dose is >30 mg, This over-ris k requires adequate detection based on sufficient knowledge of the usu al tamoxifen-related modifications in the endometrium. Physicians shou ld also be aware of two favorable effects, Tamoxifen therapy leads to decreased cardiovascular morbidity and mortality in postmenopausal wom en and is associated with a significant increase in lumbar bone densit y, Risk of interaction with oral anticoagulants has been reported, We discuss here practical steps in the follow-up of women treated with ta moxifen.