Beliefs About Medicine, Medicine Sensitivity Influence Patient Decisions on Tamoxifen Use

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Concerns about tamoxifen influence decisions to use the drug as a preventive therapy.
Concerns about tamoxifen influence decisions to use the drug as a preventive therapy.

Women at increased risk of breast cancer can choose to partake in preventive therapies, such as tamoxifen, to decrease their risk. However, according to a study published in Clinical Breast Cancer, women's personal beliefs about medicine may shape their decision against preventive breast cancer strategies.

The study authors examined if women with increased risk of breast cancer could be categorized into groups with similar perceptions about medicine and if those perceptions influenced their decision to undergo preventive therapy. Questionnaires evaluating beliefs about medicine and perceived sensitivity to medicines were given to women during standard appointments to discuss breast cancer risk.

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A total of 408 women completed the questionnaires. Overall, only 19.4% of women felt a strong need to take tamoxifen and just 14.7% of women chose to take tamoxifen as a preventive measure. Participants could be separated into 2 groups based on their perceptions about medicine: women with low necessity and lower concerns (group 1) and women with low necessity and higher concerns (group 2). Both groups did not report a strong belief that they needed tamoxifen for current or future health. Women in group 2 expressed stronger concerns about tamoxifen and medicine in general. They also had a higher perceived sensitivity to the negative side effects of medicines compared with group 1. “These women were less likely to initiate tamoxifen,” wrote the study authors.

Group 1 women had fewer concerns and were more likely to initiate tamoxifen than women in group 2. Approximately 18.3% of women in group 1 initiated tamoxifen compared with 6.4% of women in group 2. The authors note that “medication beliefs are targets for supporting informed decision-making.”


Thorneloe RJ, Horne R, Side L, Wolf MS, Smith SG; the ENGAGE Investigators. Beliefs about medication and uptake of preventive therapy in women at increased risk of breast cancer: results from a multicenter prospective study [published online December 2, 2018]. Clin Breast Cancer. doi: 10.1016/j.clbc.2018.10.008

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