Improved Uptake and Adherence to Risk-Reducing Medication with the Use of Low-Dose Tamoxifen in Patients at High Risk for Breast Cancer

Women at increased risk for breast cancer may benefit from calculation. Furthermore, 74% (n ¼ 23) of patients reported taking risk-reducing medication (RRM) with tamoxifen (tam). that they took low-dose tam after consultation, with 78.2% Historical uptake of tam in women who qualify has been low. (n ¼ 18) of those still taking medication at 1 year. Patients Recent studies have shown low-dose tam to have similar ef- who continued medication had higher estimated breast cancer ficacy to standard dosing, with lower risk for adverse events. risk compared with those who discontinued (International In this study, we aimed to evaluate uptake, adherence, and Breast Intervention Study 10-year risk, 12.7% vs. 7.6%; tolerability of low-dose tam in women at increased risk for P ¼ 0.027). All patients with DCIS initiated low-dose tam, and breast cancer and those with ductal carcinoma in situ (DCIS). only one patient with DCIS had discontinued at 1 year. Up-In this two-site prospective study, women who qualified for take of low-dose tam after informed discussion is high. Ad-breast cancer RRM were offered participation and received herence and tolerability at 1-year follow-up improved consultation with a breast specialist for discussion of RRM compared with those with traditional dosing of tam. rationale, benefits, side effects, and risks. Patients received baseline and 1-year follow-up surveys. A total of 41 patients Prevention Relevance: tam has been used extensively for consented for participation, and 31 completed 1-year follow- breast cancer prevention in high-risk women. Historical up. After initial consultation, 90% (n ¼ 37) reported good/ uptake has been low because of concern for side effects and complete understanding of breast cancer risk. Of patients in- poor tolerability. Herein, we demonstrate that in the clinical cluded in 1-year follow-up, 5 had DCIS, 13 had high-risk setting, effective patient education and offering of a low-dose intraepithelial lesion, and 13 qualified based on Breast Cancer option can improve uptake in this high-risk population. Risk Assessment Tool/International Breast Intervention Study See related Spotlight, p.