Low-Dose Tamoxifen in Noninvasive Breast Neoplasia: Long-Term Results From an Individual-Participant Data Pooled Analysis.

Low-dose tamoxifen (5 mg/day or 10 mg alternate days) vs control — pooled individual-participant analysis of 3 trials, long-term follow-up

This individual-participant pooled analysis of 3 clinical trials evaluates low-dose tamoxifen (5 mg/day or 10 mg alternate days) in women with DCIS, microinvasive carcinoma, or high-risk breast lesions. The primary endpoint is breast cancer-free interval. Long-term results confirm significant reduction in invasive or in situ recurrence risk, with a markedly more favorable adverse effect profile than 20 mg/day. Efficacy varies by menopausal status.

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Low-dose tamoxifen is progressively establishing itself as a viable alternative to standard dosing in chemoprevention, with markedly better tolerability. These long-term data are particularly relevant for BRCA2/PALB2/CHEK2 carriers with DCIS, in whom chemoprevention is under-used in practice due to poor acceptability. A gradual practice change is anticipated.

Clinical impact: 2/3 · Evidence strength: 2/3 · Novelty: 1/2 · Sample size: 1/1 · Publication status: 1/1 → Total: 7/10