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    Survival impact of tamoxifen use for breast cancer risk reduction: projections from a patient-specific Markov model

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    Authors
    Col, Nananda F.
    Goldberg, Robert J.
    Orr, Richard K.
    Erban, John K.
    Fortin, Jennifer M.
    Chlebowski, Rowan T.
    UMass Chan Affiliations
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2002-10-09
    Keywords
    Anticarcinogenic Agents
    Breast Neoplasms
    Cohort Studies
    *Decision Support Techniques
    Endometrial Neoplasms
    Female
    Humans
    Hysterectomy
    *Life Expectancy
    *Markov Chains
    Middle Aged
    Patient Selection
    *Postmenopause
    Predictive Value of Tests
    Risk Assessment
    Risk Factors
    *Survival Analysis
    Tamoxifen
    Thromboembolism
    Time Factors
    Bioinformatics
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1177/027298902236942
    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.
    Source
    Med Decis Making. 2002 Sep-Oct;22(5):386-93.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47152
    PubMed ID
    12365480
    Related Resources
    Link to Article in PubMed
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    Population and Quantitative Health Sciences Publications

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