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Published online by Cambridge University Press: 05 December 2011
The use of tamoxifen in the treatment of both metastatic and primary breast cancer is reviewed. In metastatic disease, tamoxifen slows progression in at least one-third of patients and is now the preferred first systemic therapy. Results from the larger trials of adjuvant tamoxifen are reviewed in relation to total dose and receptor status. It is suggested that variations in total dose may account for the variable results reported. Although benefit is not confined to those with tumours which are oestrogen-receptor (ER)-positive, the greatest chance of increasing disease-free survival would seem to be in those with high ER levels. Duration of tamoxifen and its effect within defined ER categories, with and without chemotherapy, are areas requiring further study by direct comparison.