Format

Send to

Choose Destination
Hered Cancer Clin Pract. 2017 Sep 20;15:14. doi: 10.1186/s13053-017-0075-8. eCollection 2017.

Motivators and barriers of tamoxifen use as risk-reducing medication amongst women at increased breast cancer risk: a systematic literature review.

Author information

1
Prince of Wales Clinical School, UNSW, Level 4, Lowy Cancer Research Centre C25, Sydney, NSW 2052 Australia.
2
School of Social Sciences and Prince of Wales Clinical School, UNSW Sydney, Kensington, NSW 2052 Australia.
3
Department of Obstetrics and Oncology, Royal Women's Hospital, University of Melbourne, Melbourne, VIC 3052 Australia.
4
Institut Paoli-Calmettes, Marseille, France.
5
Familial Cancer Service, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145 Australia.
6
Westmead Millennium Institute for Medical Research at the University of Sydney, PO Box 412, Westmead, NSW 2145 Australia.
7
Sir Peter MacCallum Dept of Oncology, University of Melbourne, Parkville, VIC 3010 Australia.
8
Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC 8006 Australia.

Abstract

BACKGROUND:

Selective estrogen receptor modulators, such as tamoxifen, reduce breast cancer risk by up to 50% in women at increased risk for breast cancer. Despite tamoxifen's well-established efficacy, many studies show that most women are not taking up tamoxifen. This systematic literature review aimed to identify the motivators and barriers to tamoxifen use 's amongst high-risk women.

METHODS:

Using MEDLINE, PsycINFO, and Embase plus reviewing reference lists of relevant articles published between 1995 and 2016, 31 studies (published in 35 articles) were identified, which addressed high-risk women's decisions about risk-reducing medication to prevent breast cancer and were peer-reviewed primary clinical studies.

RESULTS:

A range of factors were identified as motivators of, and barriers to, tamoxifen uptake including: perceived risk, breast-cancer-related anxiety, health professional recommendation, perceived drug effectiveness, concerns about side-effects, knowledge and access to information about side-effects, beliefs about the role of risk-reducing medication, provision of a biomarker, preference for other forms of breast cancer risk reduction, previous treatment experience, concerns about randomization in clinical trial protocols and finally altruism.

CONCLUSIONS:

Results indicate that the decision for high-risk women regarding tamoxifen use or non-use as a risk-reducing medication is not straightforward. Support of women making this decision is essential and needs to encompass the full range of factors, both informational and psychological.

KEYWORDS:

Breast cancer; High risk; Prevention; Risk-reducing medication; Tamoxifen

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center