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Few Primary Care Doctors Prescribe Preventive Tamoxifen

Not all patients who could benefit are getting the drug

FRIDAY, Nov. 17 (HealthDay News) -- Although tamoxifen has been approved for use as a preventive measure against breast cancer, few primary care physicians are prescribing the drug, researchers report in the Nov. 13 issue of the Archives of Internal Medicine.

Katrina Armstrong, M.D., of the University of Pennsylvania in Philadelphia, and colleagues surveyed 350 primary care physicians including those who specialize in family medicine, obstetrics and gynecology, and general internal medicine. As well as being asked about past prescription of the drug, they were posed hypothetical situations to gauge their likelihood of prescribing the drug and what factors affected their decision.

In all, 96 physicians (27.4 percent) had prescribed tamoxifen at least once in the past year as a breast cancer preventive measure. Having prescribed the medication was associated with the physician having a family member with the disease and having patients who requested information about the drug. Another significant predisposing factor was the belief that tamoxifen's benefits outweighed the risks. Primary care physicians did not give as much weight to a woman's risk of endometrial cancer as they did to familial breast cancer status.

The authors express surprise at the proportion of doctors who had prescribed the drug in the last 12 months, and conclude that the proportion is "lower than might be expected based on the estimated proportion of women who would experience a net benefit from tamoxifen."

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