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National Cancer Institute officials were described by my friend Larry Altman at the New York Times as "jubilant" when they proved tamoxifen could lower the risk of breast cancer for women at high risk. That's because their historic study provided the first major evidence that breast cancer could be prevented.

Women who took the tamoxifen had 45 percent fewer cases of breast cancer than a group of women who took a dummy pill. Remarkably, the drug worked in all age groups. That's the good news. The bad news is that tamoxifen can also kill you if you're over 50. While the number of new cases of breast cancer fell nearly by half, the numbers of new cases of cancer of the uterus nearly doubled. Women over 50 can also develop blood clots in their legs, which can work their way into the lungs, causing a life-threatening emergency. That's unfortunate because women over 50 are those who would benefit most. The greatest criticism of the study is that the federal researchers didn't wait long enough to determine if the drug actually saved lives — the ultimate end. Some fear that the drug might just delay breast cancer, rather than entirely prevent it.

Tamoxifen did have the added benefit of maintaining stronger bones but did not prevent heart attacks, as hormone replacement therapy would. Women in the study took 10 milligrams twice a day. Tamoxifen is not officially approved by the FDA for cancer prevention. The agency will review the data to determine who is best suited to take the drug. Even so, the number of women in America who qualified for the government's study was small: only 27 in 1,000 at age 40 and 93 out of 1,000 at age 50. Currently the FDA does not recommend tamoxifen to women unless they are part of a clinical trial. With all these problems, researchers say they hope for newer drugs. Fortunately, one of them is already here and it's called raloxifene.

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Women’s health