title: A lower incidence of gynecologic adverse events and interventions with anastrozole than with tamoxifen in the ATAC trial.
abstract: OBJECTIVE
  Results of the Arimidex, Tamoxifen, Alone or in Combination (ATAC) trial have shown that tamoxifen is associated with a significantly higher incidence of gynecologic adverse events than anastrozole.
  
  
  METHODS
  This was a retrospective analysis of all gynecologic adverse events and interventions conducted in patients receiving anastrozole or tamoxifen in the main ATAC trial database.
  
  
  RESULTS
  Women taking tamoxifen experienced significantly more gynecologic adverse events than those taking anastrozole (34.2% vs 20.5%; P < .0001) and this led to more diagnostic and/or therapeutic interventions, including an almost 4-fold increase in the number of hysterectomies (5.1% vs 1.3%; P < .0001). The majority of the gynecologic adverse events with tamoxifen occurred during the first 2.5 years.
  
  
  CONCLUSIONS
  The lower incidence of gynecologic adverse events and interventions with anastrozole and the early occurrence of these events provide further support for using anastrozole as the initial adjuvant treatment for early hormone receptor-positive breast cancer.
authors.affiliation: Department of Obstetrics and Gynaecology, St James's University Hospital, Leeds, United Kingdom.
authors.forename: Sean R
authors.initials: SR
authors.lastname: Duffy
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Distler
authors.forename: Anthony
authors.initials: A
authors.lastname: Howell
authors.forename: Jack
authors.initials: J
authors.lastname: Cuzick
authors.forename: Michael
authors.initials: M
authors.lastname: Baum
mesh_terms: D000077384:Anastrozole; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D005831:Genital Diseases, Female / Q000139:chemically induced*; D006801:Humans; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy*; D009570:Nitriles / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use; D014230:Triazoles / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D018931:Antineoplastic Agents, Hormonal; D009570:Nitriles; D014230:Triazoles; D013629:Tamoxifen; D000077384:Anastrozole