About one in every fourteen women in Britain will develop breast cancer at some time, the risk increasing with age. Breast cancer has a long natural history and can still prove fatal up to 30 years after diagnosis. The median survival from first recurrence is less than 2 years, but the disease may progress very slowly and some patients may live for many years without treatment. New treatments in breast cancer can therefore be assessed only by randomized controlled trials which should preferably be long term. Tamoxifen has become widely used in the treatment of all stages of carcinoma of the breast. Its proven efficacy and minimal toxicity are now well established. This article assesses its contribution to the management of this common disease.
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