In the May 15, 2013, issue of Internal Medicine Alert, in the Clinical Briefs on page 71, in the first brief titled "Risks and Benefits of an Extended 10-year Tamoxifen Regimen for Breast Cancer," we would like to make the following clarification.
A subscriber asked why the brief stated that all-cause mortality is not decreased by a longer duration of tamoxifen. In the ATLAS trial, our subscriber is correct in noting that in the ER+ subgroup of the trial, extended tamoxifen provided significant favorable results in relation to both breast cancer and total mortality outcomes. Because the primary outcome of the ATLAS trial (all participants, total mortality) did not achieve statistical significance, evidence-based medicine guidelines would typically assert that these results remain hypothesis generating, and hence not definitive. Thanks to our subscriber for suggesting this clarification.