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At this dose, fertility and reproductive indices were markedly reduced with total foetal mortality. Foetal mortality was also increased at doses of 0. Tamoxifen produced abortion, premature delivery and foetal death in rabbits administered doses equal to or greater than 0. There were no teratogenic changes in either rats or rabbits. Reduction in Invasive Breast Cancer and DCIS in Women with DCIS. Women with DCIS treated with lumpectomy and radiation therapy and who are considering tamoxifen to reduce the incidence of a second breast cancer event should assess the risks and benefits of therapy, since treatment with tamoxifen decreased the incidence of invasive breast cancer, but has not been shown to affect survival. Reduction in Breast Cancer Incidence in High-Risk Women. Women who are at high risk for breast cancer can consider taking tamoxifen therapy to reduce the incidence of breast cancer. Whether the benefits of treatment are considered to outweigh the risks depends on a woman’s personal health history and on how she weighs the benefits and risks. Tamoxifen therapy to reduce the incidence of breast cancer may therefore not be appropriate for all women at high risk for breast cancer. Women who are considering tamoxifen therapy should consult their healthcare professional for an assessment of the potential benefits and risks prior to starting therapy for reduction in breast cancer incidence. Women should understand that tamoxifen reduces the incidence of breast cancer, but may not eliminate the risk. Tamoxifen decreased the incidence of small oestrogen receptor-positive tumours, but did not alter the incidence of oestrogen receptor-negative tumours or larger tumours. In women with breast cancer who were at high risk of developing a second breast cancer, treatment with about 5 years of tamoxifen reduced the annual incidence rate of a second breast cancer by approximately 50%, oxandrolone 10mg. Women who are pregnant or who plan to become pregnant should not take tamoxifen to reduce their risk of breast cancer. Effective non-hormonal contraception must be used by all premenopausal women taking tamoxifen and for approximately 2 months after discontinuing therapy if they are sexually active. Tamoxifen does not cause infertility, even in the presence of menstrual irregularity. For sexually active women of childbearing potential, tamoxifen therapy should be initiated during menstruation. In women with menstrual irregularity, a negative B-HCG immediately prior to the initiation of therapy is sufficient. Two European trials of tamoxifen to reduce the risk of breast cancer were conducted and showed no difference in the number of breast cancer cases between the tamoxifen and placebo arms. These studies had trial designs that differed from that of NSABP P-1, were smaller than NSABP P-1, and enrolled women at a lower risk for breast cancer than those in P-1. Monitoring during Tamoxifen Therapy. Women taking or having previously taken tamoxifen should be instructed to seek prompt medical attention for new breast lumps, vaginal bleeding, gynaecologic symptoms (menstrual irregularities, changes in vaginal discharge, or pelvic pain or pressure), symptoms of leg swelling or tenderness, unexplained shortness of breath, or changes in vision. Women should inform all care providers, regardless of the reason for evaluation, that they take tamoxifen. Women taking tamoxifen to reduce the incidence of breast cancer should have a breast examination, a mammogram and a gynaecologic examination prior to the initiation of therapy. undefined

 

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