Tamoxifen as adjuvant therapy in breast cancer. Current status.

Tamoxifen retains its place as the most important drug in the management of human breast cancer. As time passes, it becomes clear that this drug is no longer to be regarded as a simple antiestrogen, since it modifies other cellular signalling mechanisms, giving scientific credence to the growth inhibitory effects observed in estrogen receptor-negative tumours. With the role of tamoxifen in breast cancer being well documented, recent interest has concentrated on its now proven efficacy in adjuvant treatment of patients with the disease in its early stages, and on its prophylactic role in women at high risk of developing the disease. For tamoxifen to have any role at all in the latter situation, it must be demonstrably safe, and here again the toxicity profile is now much better understood.