Study Shows No Stroke Risk With Tamoxifen
But Older Women Getting Chemotherapy Should Be Monitored for Stroke
Tamoxifen Experts Weigh In
Geiger's research group "is a very good epidemiological group," says Ruth M. O'Regan, MD, director of translational breast cancer research at Emory University's Winship Cancer Center in Atlanta. "I would consider this a 'real' finding regarding tamoxifen. And if you look at previous data, there is a slightly increased risk of stroke, but it's not as conclusive as other risks like [lung blood clots]."
The chemotherapy/stroke findings "surprised me most," O'Regan tells WebMD. "I'm not aware of any stroke increase with chemotherapy. But we must keep in mind this is one study, and this hasn't been shown before. I don't think you can make much of this."
She advises women over age 60 to see an internal medicine doctor regularly and to keep an eye on their stroke and other health risk factors. Factors that increase heart disease -- high cholesterol, high blood pressure, and smoking -- also increase the risk of stroke.
"Patients should be relieved about tamoxifen," says Paul Tartter, MD, professor of surgery at St. Luke's-Roosevelt Comprehensive Breast Center and Columbia University College Physicians and Surgeons in New York. "This rings with my clinical experience. I've got several thousand women in my practice and I rarely, rarely see a stroke. In fact, I don't remember ever seeing a stroke in someone taking tamoxifen."
The chemotherapy finding "worries me a little bit," Tartter tells WebMD. "It also surprises me, because someone getting chemotherapy would have low platelet count." Since platelets help the blood clot, having fewer of them should theoretically provide an anticlotting effect, which would help prevent stroke, he says. "This needs to be investigated further to find the biological explanation for it."