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Tamoxifen VTE — SCE Medical Oncology MCQ

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ModerateBreast CancerTamoxifen VTESCE Medical Oncology

A 58-year-old woman on tamoxifen for 2 years develops a unilateral swollen leg. Doppler ultrasound confirms a DVT. What is the well-recognised association between tamoxifen and VTE?

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Correct answer: C — Tamoxifen increases VTE risk approximately 2-3 fold due to its pro-oestrogenic effects on coagulation factors

Tamoxifen increases VTE risk by approximately 2-3 fold through oestrogenic effects on hepatic clotting factor synthesis (increased fibrinogen, decreased antithrombin III). The risk is highest in the first 2 years and with concurrent chemotherapy. After treating the DVT with anticoagulation, tamoxifen should be reviewed — switching to an aromatase inhibitor (if postmenopausal) eliminates the tamoxifen-associated VTE risk. AIs may have lower VTE risk but higher musculoskeletal/cardiovascular toxicity.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer