Tamoxifen Controversy

The article by Dr. Epstein and Rennie presented a flawed, factually incomplete and biased analysis. The column exaggerated the risks and avoided the benefits. As principal investigator for the trial at the City of Hope National Medical Center, one of the six trial sites in Southern California, I appreciate the concerns the authors raise. It is unfortunate, however, that their attempt to discredit this carefully designed trial is based on such emotionally charged arguments and language.

The study medication--tamoxifen--has been in use for more than 20 years in more than 25 major controlled studies involving thousands of women. Participants invited to join the trial are advised of the previous experience with tamoxifen as well as the anticipated benefits. All participants are volunteers and have the right to withdraw from the trial at any time.

The long-range benefits of the data collected in the next five years may have immense import on the health of women. These benefits may include, but are not necessarily limited to, the reduction in new breast cancers, reduction in the number of deaths from breast cancer, reduction in cardiovascular mortality and reduction or stabilization of the changes in bone density (osteoporosis).

LAWRENCE D. WAGMAN MD

Director, Department of General

Oncologic Surgery

City of Hope, Duarte