Survival Impact of Tamoxifen Use for Breast Cancer Risk Reduction: Projections from a Patient-Specific Markov Model

Nananda F. Col, Robert J. Goldberg, Richard K. Orr, John K. Erban, Jennifer M. Fortin and Rowan T. Chlebowski
Additional contact information
Nananda F. Col: Decision Systems Group and Division of General Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
Robert J. Goldberg: University of Massachusetts Medical Center, Worcester, Massachusetts
Richard K. Orr: Department of Medical Education, Spartanburg Regional Medical Center, Spartanburg, South Carolina
John K. Erban: New England Medical Center, Boston, Massachusetts
Jennifer M. Fortin: Decision Systems Group and Division of General Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
Rowan T. Chlebowski: Harbor-UCLA Research and Education Institute, Torrance, California

Medical Decision Making, 2002, vol. 22, issue 5, 386-393

Abstract: The authors estimate tamoxifen’s impact on life expectancy among healthy women. A Markov model compared the effects of 5 years of tamoxifen on survival among 50-year-old postmenopausal women. Scenarios were explored using alternative assumptions with regard to tamoxifen’s long-term effects on breast and endometrial cancer. Postmenopausal women without a uterus had substantial life expectancy gains from tamoxifen (1 to 4 months), whereas women with a uterus had such gains only if they were at a very high breast cancer risk. If tamoxifen’s impact on endometrial cancer persists after treatment is discontinued, women at high risk for endometrial cancer have life expectancy losses from tamoxifen unless they are at a very high risk for breast cancer. The authors conclude that tamoxifen use among postmenopausal women is associated with substantial life expectancy gains. However, this benefit is modulated in women at increased endometrial cancer risk and depends on assumptions concerning tamoxifen’s lingering effects on breast and endometrial cancer.

Keywords: tamoxifen; estrogen antagonists; breast cancer prevention; Markov modeling; endometrial neoplasm; breast neoplasm (search for similar items in EconPapers)
Date: 2002
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:22:y:2002:i:5:p:386-393

DOI: 10.1177/027298902236942

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