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Table 1. Predicted Benefits and Harms of 5 Years of Tamoxifen Therapy according to Age and Family History1

Variable2 Women 45 Years of Age Women 55 Years of Age Women 65 Years of Age Women 75 Years of Age
Predicted 5-year risk of breast cancer, %3 No Family history 0.7 1.1 1.5 1.6
Family history 1.6 2.3 3.2 3.4
Benefits per 1,000 women over 5 y of tamoxifen therapy Cases of invasive breast cancer avoided, n No Family history 3-4 5-6 7-8 8
Family history 8 11-12 16 17
Cases of noninvasive breast cancer avoided, n No Family history 1-2 2 2-3 2-3
Family history 2-3 3-4 4-5 5-6
Hip fractures avoided, n4 <1 3 5 15
Harms per 1000 women over 5 y of tamoxifen therapy Cases of endometrial cancer caused, n4 1-2 12 21 22
Strokes caused, n4 1 3 9 20
Pulmonary emboli caused, n4 1-2 4-5 9 18
Cases of deep venous thrombosis caused, n4 1-2 1-2 3 4

1 These estimates are based on the Gail model, outcomes from the Breast Cancer Prevention Trial, and baseline rates of harms from Gail et al.1
2 No family history = no first-degree relatives with breast cancer; family history = 1 first-degree relative with breast cancer.
3 Based on menarche at 12 years of age, first birth at 22 years of age, and no history of breast biopsy, as calculated from the Gail model.
4 Modified from Gail, et al.1

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