Arq Bras Endocrinol Metabol. 2004 Dec;48(6):903-8. Epub 2005 Mar 8.
[Use of tamoxifen in the treatment of Riedel's thyroiditis: report of a case.]
[Article in Portuguese]
Iwakura MS, Fontes R.
Instituto Estadual de Diabetes e Endocrinologia, Rio de Janeiro, RJ.

Treatment of Riedel's thyroiditis (RT) consists of surgery in cases of local limited fibrosis. In most cases, however, it is required the use of anti-inflammatory agents like glucocorticoids or, in those who fail to respond or relapse, tamoxifen can be useful. We report a case of RT in a 55-year-old black woman associated with hypothyroidism and hypoparathyroidism. We evaluated the treatment with tamoxifen, 20mg twice a day, for eleven months. After sixty days of therapy, patient had no compressive symptoms previously presented. However, in a follow-up of eleven months, there was little objective improvement by regular ultrasonography and computed tomography of the cervical region. Tamoxifen can be useful in RT, mainly when glucocorticoids are not indicated. The ideal duration of this therapy remains to be established.

Int J Oncol. 2005 Apr;26(4):1025-31.
Rationale for sequential tamoxifen and anticancer drugs in adjuvant setting for patients with node- and receptor-positive breast cancer.
Kim R, Tanabe K, Emi M, Uchida Y, Osaki A, Toge T.
Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan. rkim@hiroshima-u.ac.jp.
Since the survival benefit of tamoxifen (TAM) combined with anticancer drugs in treating node- and receptor-positive breast cancer is small, appropriate treatment schedules and the rationale for the combination remains unclear. We examined the effect of estradiol (E2) on sensitivity to anticancer drugs to clarify the survival benefit of tamoxifen combined with anticancer drugs. We used the MTT assay to assess the effect of E2 on sensitivity to anticancer drugs in the E2 receptor-positive and -negative breast cancer cell lines, MCF-7 and MDA-MB-231, respectively. We assessed the expression of apoptosis-related proteins by Western blotting, and evaluated apoptosis using the TUNEL method. Serum levels of E2 were measured using an enzyme-labeled radioimmunoassay in patients with premenopausal breast cancer before and during treatment with tamoxifen. Estrogen administration decreased sensitivity in MCF-7 cells to the anticancer drugs, adriamycin (ADM), mitomycin C (MMC), and paclitaxel (TXL), evaluated as increases in the IC50 values for ADM (4.1-fold), MMC (1.9-fold) and TXL (13.0-fold), compared with those of each drug alone. Estradiol in MDA-MB-231 cells similarly increased the IC50 values for ADM (9.5-fold), MMC (15.6-fold), and TXL (2.4-fold). The decreased sensitivity to these anticancer drugs was associated with the attenuation of apoptosis. Estrogen dose-dependently increased the expression of Bcl-2 protein in MCF-7, but not in MDA-MB-231 cells, and suppressed the expression of Bax and cytochrome c induced by anticancer drugs in association with decreased apoptosis compared with the effect of each drug alone. Phosphorylation of the Bcl-2 protein induced by TXL was decreased in the presence of E2 in MCF-7 cells. Serum levels of E2 were increased in 5 patients without amenorrhea and in 1 patient with amenorrhea after treatment with TAM alone in adjuvant therapy, compared with levels before treatment. Estradiol decreased sensitivity to ADM, MMC, and TXL in MCF-7 and MDA-MB-231 breast cancer cells, and this was associated in part with an increase in the amount of Bcl-2 protein, and decreases in levels of Bax and cytochrome c leading to apoptosis. These results suggest that therapy with TAM and anticancer drugs should be sequentially scheduled with anticancer drugs followed by TAM in an adjuvant setting to treat patients with breast cancer for a potentially improved survival benefit.

Breast Cancer Res Treat 2002 Oct;75 Suppl 1:S7-12; discussion S33-5
Tamoxifen - an update on current data and where it can now be used
Wickerham L
National Surgical Adjuvant Breast and Bowel Project, Operations Center, Pittsburgh, PA, USA

Over the past 30 years, data from a large number of clinical trials have confirmed the efficacy of tamoxifen in estrogen receptor (ER)-positive breast cancer, both as adjuvant therapy and for advanced disease. The 1995 Early Breast Cancer Trialists' Collaborative Group (EBCTCG) overview of randomized trials of adjuvant tamoxifen versus no tamoxifen showed that during approximately 10 years of follow-up, the proportional reductions in mortality for 1, 2 and approximately 5 years of adjuvant tamoxifen were 12, 17 and 26%, respectively. Tamoxifen is also effective for the prevention of breast cancer. In the National Surgical Adjuvant Breast and Bowel Project (NSABP) breast cancer prevention study (P-1), 5 years of tamoxifen therapy reduced the incidence of invasive and non-invasive breast cancers by 49 and 50%, respectively. In a randomized NSABP trial in women with ductal carcinoma in situ (DCIS), tamoxifen brought about a significant 47% reduction in ipsilateral invasive breast cancers and a 15% reduction in non-invasive breast cancers, compared with placebo. In trials performed by the Swedish Breast Cancer Co-operative Group and the NSABP, the optimal duration of adjuvant tamoxifen therapy appears to be 5 years, although this is equivocal and not yet conclusively defined.

Drug information

GENERIC NAME: tamoxifen
BRAND NAME: Nolvadex

DRUG CLASS AND MECHANISM: Tamoxifen is an antiestrogen (blocks the effect of estrogen on tissue). The precise mechanism of its action is unknown, but one possible mechanism is that it binds and blocks estrogen receptors on the surface of cells, preventing estrogens from binding and activating the cell. It is used in patients for treating and preventing breast cancer. Controversy currently exists as to which breast cancer patients will benefit from this treatment.

PREPARATIONS: 10mg oral tablets.

STORAGE: Store in a dry place at 15-30°C (59-86°F).

PRESCRIBED FOR: Tamoxifen is used for the treatment of invasive breast cancer, the most common type of breast cancer, following surgery and/or radiation and for preventing invasive breast cancer in women at high risk for developing it. Tamoxifen also is used for the treatment of women following surgery and radiation for a less common type of breast cancer called ductal carcinoma in situ (DCIS or intraductal carcinoma). Women who have had ductal carcinoma in situ are at high risk for developing invasive breast cancer at a later date, and tamoxifen prevents development of the invasive cancer in almost half of the women during the first five years of treatment. Occasionally, tamoxifen is used to stimulate ovulation.

DOSING: Tamoxifen should be taken at doses specifically directed by the physician. Currently, long term dosing is recommended (in excess of 2 years). Tamoxifen can be taken with food.

DRUG INTERACTIONS: Tamoxifen can cause abnormalities of liver tests and other blood tests, and patients taking it should keep appointments for blood work to monitor for these side effects. Patients should report any suspected side effects immediately, especially bleeding and yellowing of the skin.

SIDE EFFECTS: The most common side effects associated with tamoxifen are: hot flashes, weight gain, abnormal menstrual periods, and nausea.

Caution! Before starting to take this medicine, it is vital that you should consult your doctor! Do not use it on your own initiative, without medical advice.
Also, you should read carefully important health information about this drug given here:

my.webmd.com

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TAMOXIFEN (Breast cancer protector)
Other brand name: Nolvadex

Health information and news

Dosage	Packing	Price	Pay now
10 mg	30 tab	USD 12.00
20 mg	30 tab	USD 14.00
40 mg	30 tab	USD 19.00

Tamoxifen is a medicine that blocks the effects of the estrogen hormone in the body. It is used to treat breast cancer in women or men.
It may also be used to treat other kinds of cancer, as determined by your doctor. Tamoxifen also may be used to reduce the risk of
developing breast cancer in women who have a high risk of developing breast cancer.